Efficacy of high-dose palliative radiotherapy for localised, castration-resistant prostate cancer

Clin Oncol (R Coll Radiol). 2015 Jan;27(1):16-21. doi: 10.1016/j.clon.2014.09.013. Epub 2014 Oct 14.

Abstract

Aims: There are limited outcome data after radiotherapy treatment for clinically localised, castration-resistant prostate cancer. We report our single institution experience on patient outcomes in this group using high-dose palliative radiotherapy (HDPRT).

Materials and methods: A retrospective review of patient hospital records was conducted in prostate cancer patients treated with palliative intent radiotherapy and restricted to those who had castration-resistant disease, no evidence of regional or distant disease and who received a local radiotherapy dose equivalent to 40 Gy or greater.

Results: Fifty-one patients met the study criteria, 88% of these had high-risk disease at initial diagnosis. The median time to delivery of HDPRT was 66 months and the median follow-up from HDPRT was 54 months. Grade 3 or worse toxicity was experienced in 8%. The estimated freedom from local failure, cause-specific survival and overall survival at 5 years were 81, 65 and 35%, respectively. Local procedures were a significant contributor to local morbidity, with the most common procedure a transurethral resection of the prostate (27% patients). Only two patients died from complications of local failure.

Conclusion: HDPRT was well tolerated and provided a high rate of local control in a clinically localised castration-resistant prostate cancer population. Although prostate cancer remained the most frequent cause of death, some patients had extended survival without evidence of disease progression.

Keywords: Castration-resistant prostate cancer; palliative; radiotherapy.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Dose-Response Relationship, Radiation
  • Humans
  • Male
  • Middle Aged
  • Palliative Care / methods*
  • Prostatic Neoplasms, Castration-Resistant / radiotherapy*
  • Radiotherapy Dosage
  • Retrospective Studies
  • Treatment Failure
  • Treatment Outcome