Home > Journals > Minerva Urology and Nephrology > Past Issues > Minerva Urologica e Nefrologica 2019 October;71(5) > Minerva Urologica e Nefrologica 2019 October;71(5):508-15

CURRENT ISSUE
 

JOURNAL TOOLS

Publishing options
eTOC
To subscribe
Submit an article
Recommend to your librarian
 

ARTICLE TOOLS

Publication history
Reprints
Permissions
Cite this article as
Share

 

ORIGINAL ARTICLE   Free accessfree

Minerva Urologica e Nefrologica 2019 October;71(5):508-15

DOI: 10.23736/S0393-2249.19.03388-5

Copyright © 2019 EDIZIONI MINERVA MEDICA

language: English

Multimodal treatment for high-risk locally-advanced prostate cancer following radical prostatectomy and extended lymphadenectomy

Fabio ZATTONI 1 , Alessandro MORLACCO 1, 2, Fabio MATRONE 3, Mauro ARCICASA 3, Lorenzo BUTTAZZI 4, Daniele MARUZZI 4, Lucia FRATINO 5, Giovanni LO RE 5, Roberto BORTOLUS 3

1 Department of Surgery, Oncology, and Gastroenterology, University of Padua, Padua, Italy; 2 Department of Oncological and Surgical Sciences, Clinic of Urology, University of Padua, Padua, Italy; 3 Department of Radiotherapy, National Cancer Institute (CRO), Aviano, Pordenone, Italy; 4 Department of Urology, General Hospital of Pordenone, Pordenone, Italy; 5 Department of Medical Oncology, National Cancer Institute (CRO), Aviano, Pordenone, Italy



BACKGROUND: The aim of this study was to prospectively evaluate the safety and oncologic outcomes of multimodal treatment in high risk-locally advanced prostate cancer patients (PCa).
METHODS: High-risk-locally advanced prostate cancer patients without distant metastases before radical prostatectomy (RP) were included. Adjuvant high-dose intensity-modulated radiation therapy (IMRT) with concurrent docetaxel and long-term androgen-deprivation therapy (ADT) were started after 3-6 months from RP. ADT was maintained for two years. Acute and late toxicity were evaluated with the Common Terminology Criteria for Adverse Events (v. 3.0). Biochemical and clinical recurrence-free survival were explored by using the Kaplan-Meier method.
RESULTS: Overall 42 patients were included. Acute genitourinary toxicity was observed with Grade I, II, and III in four (9.5%), two (4.8%), and one (2.3%) patients, respectively. Acute gastrointestinal toxicity was reported to be of Grade I and II in 12 (29.3%) and three (7.2%) patients, respectively. In these patients, concomitant genito-urinary and gastrointestinal toxicity occurred in three (7.2%) cases. A residual GU Grade I toxicity was present only in one patient. Toxicity due to CHT was found in four (9.5%) patients. Complete continence after RP and IMRT was achieved in 32 patients (76.2%). After a median follow-up of 3.4 years, BCR and clinical recurrence were observed in 16.7% and 9.5% of patients, respectively. A 5-year biochemical and clinical recurrence-free survival rate were 70.7% and 84.0%, respectively. Five-year overall survival was 93.6%. None of the patients died for prostate cancer during follow-up.
CONCLUSIONS: This novel multimodal treatment paradigm for high-risk locally advanced prostate cancer has an acceptable level of toxicity and good oncological outcomes observed after a long follow-up.


KEY WORDS: Prostatic neoplasms; Prostatectomy; Radiotherapy; Drug therapy; Combined modality therapy

top of page