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External beam radiation monotherapy for localized or locally advanced prostate cancer
Atsushi Takahashi1, Masahiro Yanase, Naoya Masumori
1Department of Urology, Sapporo Medical University School of Medicine, Sapporo, Japan. atakahas@sapmed.ac.jp
Purpose:
We report the treatment results and complications of external beam radiation monotherapy for localized or locally advanced prostate cancer patients.
Methods:
Fifty-four patients with T(1b-3a)N(0)(pN(0))M(0) prostate cancer were treated with external beam radiation monotherapy between 1989 and 2001 at four institutes.
Results:
During the 4-122 month follow-up period (median: 25 months), 11 (20%) patients experienced biochemical failure, including one with simultaneous local recurrence. The 2-year actuarial biochemical control rate was 85%. Univariate analysis showed that the clinical T classification (P = 0.01), Gleason score (P = 0.006), pretreatment PSA (P = 0.02) and PSA nadir value (P = 0.01) were associated with a higher probability of biochemical failure. Multivariate analysis using the Cox proportional hazards model demonstrated that only the PSA nadir value was a strong predictor of PSA recurrence (P < 0.01). Adverse events were mild and tolerable. No severe urinary or bowel complications were observed.
Conclusions:
External beam radiation monotherapy is effective for clinically organ-confined prostate cancer with a low incidence of severe complications in a mean follow-up period of 2 years.