MP53-14 MULTIMODAL TREATMENT FOR HIGH-RISK PROSTATE CANCER WITH HIGH-DOSE INTENSITY-MODULATED RADIATION THERAPY, CONCURRENT INTENSIFIED-DOSE DOCETAXEL AND LONG-TERM ANDROGEN DEPRIVATION THERAPY AFTER RADICAL PROSTATECTOMY AND LYMPHADENECTOMY: RESULTS OF A PROSPECTIVE PHASE II TRIAL.

Abstract

You have accessJournal of UrologyProstate Cancer: Advanced (including Drug Therapy) III1 Apr 2017MP53-14 MULTIMODAL TREATMENT FOR HIGH-RISK PROSTATE CANCER WITH HIGH-DOSE INTENSITY-MODULATED RADIATION THERAPY, CONCURRENT INTENSIFIED-DOSE DOCETAXEL AND LONG-TERM ANDROGEN DEPRIVATION THERAPY AFTER RADICAL PROSTATECTOMY AND LYMPHADENECTOMY: RESULTS OF A PROSPECTIVE PHASE II TRIAL. Fabio Zattoni, Roberto Bortolus, Alessandro Morlacco, Mauro Arcicasa, Fabio Matrone, and Filiberto Zattoni Fabio ZattoniFabio Zattoni More articles by this author , Roberto BortolusRoberto Bortolus More articles by this author , Alessandro MorlaccoAlessandro Morlacco More articles by this author , Mauro ArcicasaMauro Arcicasa More articles by this author , Fabio MatroneFabio Matrone More articles by this author , and Filiberto ZattoniFiliberto Zattoni More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.1665AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES To evaluate the safety and oncologic outcomes of adjuvant chemo (CHT), high-dose intensity-modulated radiation therapy (IMRT) and long-term androgen deprivation (ADT) therapy following radical prostatectomy (RP) and extended lymphadenectomy (PLND) in high risk prostate cancer patients. METHODS Data of patients were collected in prospectively maintained database after IRB approval. Inclusion criteria of the study were: 1) high-risk localized (PSA level ≥20 ng/ml or clinical stage T2c or Gleason score ≥8) or locally advanced (clinical stage T3 or N+, any PSA level, any Gleason score) prostate cancer after RP and PLND 2) patients suitable to receive CHT and RT after surgery. Exclusion criteria were: 1) uncontrolled chronic disease; severe infection; peripheral neuropathy or prior malignancy within the last 5 years before study entry; 2) prior CHT, pelvic RT or local treatments for prostate cancer. Adjuvant IMRT with concurrent Docetaxel and long-term ADT were stared after 3-6 months form surgery. IMRT was performed in 4 to 6 field technique with 15-to 18-MV. Docetaxel was administered in a standard 1-hour intravenous weekly dose (30 mg if body surface area <1.8 m2 and 40 mg if body surface area ≥1.8 m2) for 6-7 weeks. ADT was maintained for 2 years. Acute and late toxicity were evaluated with the Common Terminology Criteria for Adverse Events version 3.0. Biochemical and clinical recurrence-free survival were explored with the Kaplan-Meier method. RESULTS Overall 42 patients were included in the study. Acute Genito-Urinary (GU) toxicity was observed with grade I, II and III in 4 (9.5%), 2 (4.8%), and 1 (2.3%) patients, respectively. Acute Gastro-Intestinal (GI) toxicity was found found with grade I and II in 12 (29.3%) and 3 (7.2%), respectively. In those patients with acute toxicity, concomitant GU and GI toxicity occurred in 3 (7.2%) cases. No acute grade ≥IV toxicity was detected. A residual GU grade I toxicity was present only in 1 patient. Allergy due to CHT has been evaluated in 3/42 (7.1%) patients. Continence (defined as absence of any urinary leak) after RP and post IMRT was achieved in 29 (69%) and 27 (64.3%), respectively. After a median follow up of 3.4 years, a PSA recurrence and clinical recurrence were observed in 7 (16.7%) and 4 (9.5%) patients. A 5-year biochemical and clinical recurrence-free survival rate were 70.7% and 84.0%, respectively. 5-year overall free survival was 93.6%. None of patients died for prostate cancer during follow up. CONCLUSIONS This phase II trial test a novel multimodal treatment paradigm for high-risk prostate cancer. Toxicity was acceptably low and long term oncological outcomes were good. Further studies are needed to compare this novel treatment paradigm to the standard of care. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e718-e719 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Fabio Zattoni More articles by this author Roberto Bortolus More articles by this author Alessandro Morlacco More articles by this author Mauro Arcicasa More articles by this author Fabio Matrone More articles by this author Filiberto Zattoni More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...