Impact of Androgen Deprivation Therapy Associated to Conformal Radiotherapy in the Treatment of D’Amico Intermediate-/High-Risk Prostate Cancer in Older Patients

Purpose/objective: The association of 3D Conformal External Beam Radiotherapy (3D-CEBRT) with adjuvant Androgen Deprivation Therapy (ADT) proved to treat patients with intermediate- and high-risk localized prostate cancer (IR and HR). However, older patients were underrepresented in literature. We a...

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Main Authors: Anne-Laure Couderc, Emanuel Nicolas, Romain Boissier, Mohammed Boucekine, Cyrille Bastide, Delphine Badinand, Dominique Rossi, Benedicte Mugnier, Patrick Villani, Gilles Karsenty, Didier Cowen, Eric Lechevallier, Xavier Muracciole
Format: Article
Language:English
Published: MDPI AG 2020-12-01
Series:Cancers
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Online Access:https://www.mdpi.com/2072-6694/13/1/75
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Summary:Purpose/objective: The association of 3D Conformal External Beam Radiotherapy (3D-CEBRT) with adjuvant Androgen Deprivation Therapy (ADT) proved to treat patients with intermediate- and high-risk localized prostate cancer (IR and HR). However, older patients were underrepresented in literature. We aimed to report the oncological results and morbidity 3D-CEBRT +ADT in ≥80 years patients. Material and Methods: From June 1998 to July 2017, 101 patients ≥80 years were included in a tertiary center. The median age was 82 years. ADT was initiated 3 months prior 3D-CEBRT in all patients, with a total duration of 6 months for IR prostate cancer (group A; <i>n</i> = 41) and 15 months for HR prostate cancer (group B; <i>n</i> = 60). Endpoints included overall survival (OS), metastasis-free survival (DMFS), biochemical recurrence-free survival (BRFS) and toxicity. Results: Five years-OS was 95% and 86.7% in groups A and B, respectively. Cardiovascular events occurred in 22.8% of ≥80 years patients with no impact on OS. In the multivariate analysis, age <82 years, Karnofsky index and normalization of testosterone levels were significantly associated with better OS. Conclusion: Age ≥80 years should not be a limitation for the treatment of IR and HR prostate cancer patients with 3D-CEBRT and ADT, but cardiovascular monitoring and prevention are mandatory.
ISSN:2072-6694