Disease relapses after radical radiotherapy of prostate cancer: Analysis of prognostic factors

Abstract

INTRODUCTION Although there is no consensus on which is the best option in prostate cancer treatment, these patients could be successfully treated with radiotherapy. Regarding some prognostic factors, it is possible today to classify prostate cancer patients into several risk groups for clinical and biochemical relapse, and therefore to choose the right treatment modality. OBJECTIVE The objective in our study was to analyze the impact of tumor stage and grade, previous transurethral resection of the prostate (TUR), initial prostate specific antigen (PSA) level and age on disease relapse after radical radiotherapy of the prostate cancer. METHOD Between January 1991 and December 2005, a clinical, retrospective study was performed at the Radiotherapy Department of the Institute for Oncology and Radiology of Serbia, which included 283 patients with prostate cancer treated only with radical radiotherapy. During regular follow-up we analyzed response to treatment and disease relapse. RESULTS After radical radiotherapy disease relapse more often occurred (with statistical significance) in patients with locally advanced tumor (stage C 35% vs. A 13% vs. B 19%), low tumor grade (grade III 38% vs. grade II 23% vs. grade I 17%), initial PSA level over 10 ng/ml (29%) and over 20 ng/ml (37%) compared to 11% in the patients with initial PSA level below10 ng/ml, and patients of lower age (less than 55 years 50% vs. 16% in patients over 70 years). CONCLUSION Tumor stage C, low tumor grade (grade II-III), initial PSA level over 10 ng/ml (over 20 ng/ml) and younger age are poor prognostic factors for disease relapse. In this case, radiotherapy as monotherapy is not an adequate approach, and it needs to be combined with other therapeutic modalities.

Keywords

• prostate cancer
• radical radiotherapy
• disease relapse
• prognostic factors