Abstract
Background: Radiation therapy has undergone significant technical development in the past decade. However, the complex therapy of intermediate-risk patients with organ-confined prostate carcinoma still poses many questions. Our retrospective study investigated the impact of selected components of the treatment process including radiotherapy, hormone deprivation, risk classification, and patients’ response to therapy. Methods: The impact of delivered dose, planning accuracy, duration of hormone deprivation, risk classification, and the time to reach prostate-specific antigen (PSA) nadir state were analyzed among ninety-nine individuals afflicted with organ-confined disease. Progression was defined as a radiological or biochemical relapse within five years from radiotherapy treatment. Results: We found that 58.3% of the progressive population consisted of intermediate-risk patients. The progression rate in the intermediate group was higher (21.9%) than in the high-risk population (12.1%). Dividing the intermediate group, according to the International Society of Urological Pathology (ISUP) recommendations, resulted in the non-favorable subgroup having the highest rate of progression (33.3%) and depicting the lowest percentage of progression-free survival (66.7%). Conclusion: Extended pelvic irradiation on the regional lymph nodes may be necessary for the ISUP Grade 3 subgroup, similarly to the high-risk treatment. Therapy optimization regarding the intermediate-risk population based on the ISUP subgrouping suggestions is highly recommended in the treatment of organ-confined prostate cancer.
Highlights
Due to early detection and a widely adopted screening policy, prostate malignancies are generally recognized in the early stages
Whether the increased efficacy of combining Androgen deprivation therapy (ADT) and external beam radiation therapy (EBRT) is the result of an improved local treatment or the systemic eradication of micro-metastases, or the combination of both, remains as of yet, an unanswered question
99 patients were included in our study in which we investigated the impact of selected components, including radiotherapy data, hormone deprivation, risk classification, and the patients’ response to therapy regarding progressionfree survival
Summary
Due to early detection and a widely adopted screening policy, prostate malignancies are generally recognized in the early stages. Androgen deprivation therapy (ADT) combined with radiation have been shown to increase survival in males with intermediate and high risk of relapse [2,3], as well as local and systemic effects. An increasing number of patients with favorable and unfavorable intermediate- and high-risk adenocarcinoma of the prostate have been treated using a combination of ADT and primary EBRT [4,5], which is likely an appropriate and effective form of treatment. Dividing the intermediate group, according to the International Society of Urological Pathology (ISUP) recommendations, resulted in the non-favorable subgroup having the highest rate of progression (33.3%) and depicting the lowest percentage of progressionfree survival (66.7%). Therapy optimization regarding the intermediate-risk population based on the ISUP subgrouping suggestions is highly recommended in the treatment of organ-confined prostate cancer
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
