Five-year outcomes after neoadjuvant chemotherapy and conformal radiotherapy in patients with high-risk localized prostate cancer Journal Article
| Authors: | Ryan, C. J.; Zelefsky, M. J.; Heller, G.; Regan, K.; Leibel, S. A.; Scher, H. I.; Kelly, W. K. |
| Article Title: | Five-year outcomes after neoadjuvant chemotherapy and conformal radiotherapy in patients with high-risk localized prostate cancer |
| Abstract: | Objectives To describe the 5-year outcomes of patients with high-risk localized prostate cancer treated with neoadjuvant estramustine and vinblastine followed by concurrent chemotherapy and three-dimensional conformal radiotherapy (3D-CRT). Methods A total of 23 patients completed therapy consisting of two 8-week cycles of vinblastine, weekly as 4 mg/m2, followed by 8 weeks of concomitant chemotherapy and 3D-CRT. Estramustine was given daily at 10 mg/kg in three divided doses. 3D-CRT consisted of a total dose of 7560 cGy. Results Assessable patients include 9 with Stage T3 or greater tumors and 5 with lymph node metastasis at diagnosis. All patients had a Gleason score 7 or greater. The median follow-up was 60 months. Of the 23 assessable patients, 15 (65%) experienced biochemical relapse by American Society for Therapeutic Radiology Oncology criteria. The median time to prostate-specific antigen relapse was 12 months (range 7 to 16). Five patients (22%) developed metastases. The median time to metastasis had not been reached by last follow-up. Of the 23 assessable patients, 11 (48%) received no additional therapy and had noncastrate testosterone levels. Six patients had no evidence of disease and 9 patients were receiving androgen blockade. Three patients died (one of prostate cancer and two of other diseases). Conclusions A substantial proportion of patients with unfavorable-risk localized prostate cancer achieved long-term disease control with estramustine and vinblastine and concurrent 3D-CRT, no significant long-term toxicities were seen and 48% underwent no further therapy after RT. These long-term findings support the continued study of chemotherapy combined with RT as a potential alternative to prolonged androgen deprivation. © 2004 Elsevier Inc. |
| Keywords: | adult; cancer chemotherapy; clinical article; controlled study; treatment outcome; aged; disease-free survival; middle aged; survival analysis; clinical trial; cancer localization; side effect; cancer radiotherapy; combined modality therapy; neoadjuvant therapy; cancer staging; follow up; follow-up studies; adenocarcinoma; controlled clinical trial; antineoplastic combined chemotherapy protocols; tumor markers, biological; vinblastine; risk; prostate-specific antigen; prostatic neoplasms; feasibility studies; acetylsalicylic acid; thromboembolism; androgen antagonists; neoplasm metastasis; radiotherapy, conformal; antineoplastic agents, hormonal; testosterone; prostate carcinoma; estramustine; brain artery aneurysm; humans; prognosis; human; male; priority journal; article |
| Journal Title: | Urology |
| Volume: | 64 |
| Issue: | 1 |
| ISSN: | 0090-4295 |
| Publisher: | Elsevier Science, Inc. |
| Date Published: | 2004-07-01 |
| Start Page: | 90 |
| End Page: | 94 |
| Language: | English |
| DOI: | 10.1016/j.urology.2004.03.006 |
| PROVIDER: | scopus |
| PUBMED: | 15245942 |
| DOI/URL: | |
| Notes: | Urology -- Cited By (since 1996):20 -- Export Date: 16 June 2014 -- CODEN: URGYA -- Source: Scopus |
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