Radiotherapy With Hyperthermia for Prostatic Ductal Adenocarcinoma: Primary and Salvage Cases

Prostatic ductal adenocarcinoma (PDA) is a rare and aggressive histological variant of prostate cancer associated with a high risk of treatment failure and poor survival compared to conventional acinar adenocarcinoma. We report three cases of PDA treated with radiotherapy combined with regional hyperthermia.

Two patients with locally advanced PDA (cT3aN0M0) were treated with definitive intensity-modulated radiotherapy combined with regional hyperthermia. One patient with biochemical recurrence following radical prostatectomy (pT3aN0M0) received salvage three-dimensional conformal radiotherapy with regional hyperthermia. Therapeutic heating was achieved in all cases, with thermal doses (CEM43T90) of 5.2, 6.1, and 2.3 min, respectively. Long-term clinical control was observed in all patients, with follow-up durations of six, nine, and eight years, respectively. In the salvage case, a secondary prostate-specific antigen increase occurred but was successfully controlled with short-term hormonal therapy, with no subsequent clinical progression.

Radiotherapy combined with regional hyperthermia may represent a promising treatment strategy for achieving durable clinical control in patients with PDA.