Clinical outcomes from dose-reduced radiotherapy to the prostate in elderly patients with localized prostate cancer

Nina Samson, Rutvij A. Khanolkar, Sarah Quirk, Harvey Quon, Michael Roumeliotis, Alex Balogh, Michael Sia, Kundan Thind, Siraj Husain, Kevin Martell

Research output: Contribution to journalArticlepeer-review

Abstract

Radical treatment of localized prostate cancer in elderly patients may lead to unacceptable treatment-associated toxicities that adversely impact quality of life without improving survival outcomes. This study reports on a cohort of 54 elderly (>70 years) patients that received 4000–5000 cGy of palliative external beam radiotherapy (EBRT) as an alternative to androgen deprivation therapy (ADT). The primary outcome of interest was the period of ADT-free survival, and secondary outcomes included overall survival (OS) and metastases-free survival (MFS). Kaplan–Meier regression was used to estimate survival outcomes. Thirty-six (67%) patients achieved a break in ADT post-radiotherapy, with a median time to ADT reinitiation of 20 months. Common Terminology Criteria for Adverse Events (CTCAE) were limited to low-grade gastrointestinal (GI) or genitourinary (GU) toxicities, with no skin toxicities observed. Grade 1 GI toxicity was observed in 9 (17%) patients, and grades 1 and 2 GU toxicities were observed in 13 (24%) and 3 (6%) patients, respectively, with no higher-grade toxicities reported. Five-year MFS and OS were 56% and 78%, respectively. In summary, the treatment regimen was well-tolerated and achieved durable ADT-free survival in most patients. Dose-reduced EBRT appears to be a viable alternative to ADT in elderly patients with localized prostate cancer.

Original languageEnglish (US)
Pages (from-to)3729-3737
Number of pages9
JournalCurrent Oncology
Volume28
Issue number5
DOIs
StatePublished - 2021
Externally publishedYes

Keywords

  • Elderly
  • Palliation
  • Prostate cancer
  • Treatment

ASJC Scopus subject areas

  • Oncology

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