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Klayton TL , Ruth K , Horwitz EM , Uzzo RG , Kutikov A , Chen DYT , Sobczak M , Buyyounouski MK
Young age under 60 years is not a contraindication to treatment with definitive dose escalated radiotherapy for prostate cancer
Radiotherapy and Oncology. 2011 Dec;101(3) :508-512
PMID: WOS:000298894700028    PMCID: PMC3225561   
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Abstract
Background: It is widely believed that younger prostate cancer patients are at greater risk of recurrence following radiotherapy (RI). Methods: From 1992 to 2007, 2168 (395 age <= 60) men received conformal RI alone for prostate cancer at our institution (median dose = 76 Gy, range: 72-80). Multivariable analysis (MVA) was used to identify significant predictors for BF and PCSM. Cumulative incidence was estimated using the competing risk method (Fine and Gray) for BF (Phoenix definition) and PCSM to account for the competing risk of death. Results: With a median follow-up of 72.2 months (range: 24.0-205.1), 8-year BF was 27.1% for age <= 60 vs. 23.7% for age >60 (p = 0.29). Eight-year PCSM was 3.0% for age <= 60 vs. 2.0% for age >60 (p = 0.52). MVA for BF identified initial PSA [adjusted HR = 1.7 (PSA 10-20), 2.6 (PSA >20), p < 0.01], Gleason score [adjusted HR = 2.1 (G7), 1.9 (G8-10), p < 0.011, T-stage [adjusted HR = 1.7 (T2b-c), 2.6 (T3-4), p < 0.01], and initial androgen deprivation therapy (ADT) [adjusted HR = 0.38 (ADT >12 months), p < 0.01] as significant, but not age or ADT <12 months. MVA for PCSM identified Gleason score [adjusted HR = 3.0 (G8-10), p = 0.011 and T-stage [adjusted HR = 8.7 (13-4), p < 0.01] as significant, but not age. PSA, or ADT. Conclusion: This is the largest, most mature study of younger men treated with RI for prostate cancer that confirms young age is not prognostic for BF. (C) 2011 Elsevier Ireland Ltd. All rights reserved. Radiotherapy and Oncology 101 (2011) 508-512
Notes
Klayton, Tracy L. Ruth, Karen Horwitz, Eric M. Uzzo, Robert G. Kutikov, Alexander Chen, David Y. T. Sobczak, Mark Buyyounouski, Mark K. 44 Elsevier ireland ltd Clare 873pg