Organ preservation in the management of prostatic cancer

Thirty-two patients with cT2 prostatic adenocarcinoma underwent a protocol of combined treatment based on: neoadjuvant hormonotherapy (LH-RH analogues + antiandrogens) and concomitant external radiotherapy (ERT), two months before ERT until the end of it; ERT to the entire pelvis (45 Gy) with a boost dose to the prostatic volume (+20 Gy). All patients completed the planned treatment. Acute toxicity was moderate (Gr 1-2 RTOG). At a median follow-up of 22 months (range: 6-68) one patient (3.1%) showed bone metastases while none had local disease progression. Overall 5 year survival and disease-free survival were 100% and 97% respectively. Late toxicity was mild (Gr 1 RTOG: intestinal: 3.1%; urological: 21.9%). The protocol was shown to be feasible with no relevant toxicity. Even if the follow-up was short, results achieved in this group of potentially resectable prostatic cancer patients seem to confirm the possibility of achieving results comparable to those of surgery with no relevant impairment of urinary and intestinal function, thus with an acceptable quality of life.