The Korean Journal of Urological Oncology 2004;2(3):154-160.
Published online September 30, 2004.
국소적 또는 국소진행성 전립선암 환자에서의 신보조적 안드로젠 차단과 외부 방사선 병행 치료
조강수, 양원재, 진옥현, 조재호1, 홍성준
연세대학교 의과대학 비뇨기과학교실, 비뇨의과학연구소, 1방사선종양학과
The Clinical Experience of Localized or Locally Advanced Prostate Cancer Treated with Neoadjuvant Hormone Therapy and External Beam Radiotherapy
Kang Su Cho , Won Jae Yang , Ok Hyun Chin , Jae Ho Cho 1, Sung Joon Hong
0Departments of Urology, Urological Science Institute, Korea
1Departments of Urology, Radiation Oncology, Yonsei University College of Medicine, Seoul, Korea
Correspondence:  Sung Joon Hong
Abstract
Purpose
We evaluated the clinical outcome in patients with localized or locally advanced prostate cancer treated with neoadjuvant hormone therapy(NHT) and external beam radiotherapy(EBRT) and also identified the prognostic factors which influence biochemical recurrence. Materials and Methods: Between 1994 and 2003, data on 28 patients who were treated with a 4-month course of NHT and a 7-week course of EBRT were retrospectively analyzed. The mean age was 71.2 years old (47-82) and the mean follow-up duration was 40.1 months(12-91). Results: The mean pretreatment prostate specific antigen(PSA) level was 38.0ng/ml(1.1-113.2), and the median Gleason's score was 7(4-10). The clinical stage was T1 in 10, T2 in 10, T3 in 6 and T4 in 4. Five-year recurrence-free probability was 44.5%. In univariate analysis, the time to recurrence was significantly shorter in the patients with age<70 years, Gleason's score≥8, stage≥T3 and PSA≥50ng/ml(p<0.05), however, the prostate volume did not seem to have significant influence on biochemical recurrence(p>0.05). The multivariate analysis revealed that the pretreatment PSA level was independently associated with time to recurrence(p<0.05). No severe complication was observed in all patients and the observed minor complications were dysuria in 7 patients, frequency in 4, urge incontinence in 2, proctitis in 3 and abdominal discomfort in 2. Conclusions: NHT and EBRT showed generally effective tumor control without severe complication. The pretreatment PSA level was a independent prognostic factor and a long-term adjuvant hormone therapy is required in the patients with pretreatment PSA 50ng/ml or greater. (Korean J Uro-Oncol 2004;2:154-160)
Key Words: Prostatic neoplasm, Androgen, Neoadjuvant therapy, Radiotherapy


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