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Panminerva Medica 2017 Mar 03

DOI: 10.23736/S0031-0808.17.03232-3

Copyright © 2017 EDIZIONI MINERVA MEDICA

language: English

Prognostic factors in 1080 prostate cancer patients treated by radical external beam radiotherapy

Elisabetta GARIBALDI 1 , Domenico GABRIELE 2, Angelo MAGGIO 3, Elena DELMASTRO 1, Monica GARIBALDI 2, Filippo RUSSO 4, Sara BRESCIANI 3, Michele STASI 3, Pietro GABRIELE 1

1 Radiotherapy Unit of Candiolo Cancer Center, FPO‐IRCCS, Candiolo, Turin, Italy; 2 Neuroscience Department, Physiology Unit, University of Turin, Turin, Italy; 3 Medical Physic Unit of Candiolo Cancer Center, FPO‐IRCCS, Candiolo, Turin, Italy; 4 Radiology Unit of Candiolo Cancer Center, FPO‐IRCCS, Candiolo, Turin, Italy


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INTRODUCTION: The aim of this paper was to analyze, retrospectively, in prostate cancer patients treated in our Centre with external beam radiotherapy, the prognostic factors and their impact on the outcome in terms of Cancer Specific Survival (CSS), Biochemical Disease Free Survival (BDFS) and Clinical Disease Free Survival (CDFS).
MATERIAL AND METHODS: From October 1999 and March 2012 we treated with radiotherapy, 1080 patients. Eighty-seven percent of patients were classified as < cT2, 83% had a Gleason Score (GS) < 7; the mean of iPSA was 18 ng/mL; the rate of clinical positive nodes was 1%. The mean follow-up was 81 months.
RESULTS: The statistically significant prognostic factors for all groups of patients at both, univariate and multivariate analysis, were the GS and the iPSA. In intermediate and high/very-high risk patients at multivariate analysis other prognostic factors for CSS were: positive nodes on CT scan and rectal preparation during the treatment; for the BDFS: patient risk classification, positive lymph nodes on CT scan and rectal/bladder preparation; for the CDFS: number of positive core on biopsy (p=0.003), positive lymph nodes on CT scan and RT dose. In high/very-high risk patient group at multivariate analysis other prognostic factors for CSS were: clinical/radiological stage, RT dose; for BDFS: adjuvant hormone therapy, clinical/radiological stage and RT dose>77.7 Gy; for CDFS: clinical/radiological stage and RT dose>77.7 Gy.
CONCLUSIONS: Our results confirm prognostic factors described by literature, adding as new prognostic factor the rectal/bladder preparation, generally known for its effect on toxicity but not yet on outcome.


KEY WORDS: Prostate cancer - External beam radiotherapy - Prognostic factors - Outcome

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elisabetta.garibaldi@ircc.it