Should We Reconsider the Necessity of a Refinement of Prostate Cancer Risk Classification and Radiotherapy Treatment Strategy? Experiences from a Retrospective Analysis of Data from a Single Institution
Background: Radiation therapy has undergone significant technical development in the past decade. However, the complex therapy of intermediate-risk patients with organ-confined prostate carcinoma still poses many questions. Our retrospective study investigated the impact of selected components of th...
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| Format: | Article |
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MDPI AG
2020-12-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/10/1/110 |
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| author | Viktória Temesfői Róbert Herczeg Zoltán Lőcsei Klára Sebestyén Zsolt Sebestyén László Mangel Miklós Damásdi |
| author_facet | Viktória Temesfői Róbert Herczeg Zoltán Lőcsei Klára Sebestyén Zsolt Sebestyén László Mangel Miklós Damásdi |
| author_sort | Viktória Temesfői |
| collection | DOAJ |
| description | Background: Radiation therapy has undergone significant technical development in the past decade. However, the complex therapy of intermediate-risk patients with organ-confined prostate carcinoma still poses many questions. Our retrospective study investigated the impact of selected components of the treatment process including radiotherapy, hormone deprivation, risk classification, and patients’ response to therapy. Methods: The impact of delivered dose, planning accuracy, duration of hormone deprivation, risk classification, and the time to reach prostate-specific antigen (PSA) nadir state were analyzed among ninety-nine individuals afflicted with organ-confined disease. Progression was defined as a radiological or biochemical relapse within five years from radiotherapy treatment. Results: We found that 58.3% of the progressive population consisted of intermediate-risk patients. The progression rate in the intermediate group was higher (21.9%) than in the high-risk population (12.1%). Dividing the intermediate group, according to the International Society of Urological Pathology (ISUP) recommendations, resulted in the non-favorable subgroup having the highest rate of progression (33.3%) and depicting the lowest percentage of progression-free survival (66.7%). Conclusion: Extended pelvic irradiation on the regional lymph nodes may be necessary for the ISUP Grade 3 subgroup, similarly to the high-risk treatment. Therapy optimization regarding the intermediate-risk population based on the ISUP subgrouping suggestions is highly recommended in the treatment of organ-confined prostate cancer. |
| first_indexed | 2024-03-10T13:39:00Z |
| format | Article |
| id | doaj.art-b62a2aa2a6c14a8d8a54d4a4a7615805 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T13:39:00Z |
| publishDate | 2020-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-b62a2aa2a6c14a8d8a54d4a4a76158052023-11-21T03:12:12ZengMDPI AGJournal of Clinical Medicine2077-03832020-12-0110111010.3390/jcm10010110Should We Reconsider the Necessity of a Refinement of Prostate Cancer Risk Classification and Radiotherapy Treatment Strategy? Experiences from a Retrospective Analysis of Data from a Single InstitutionViktória Temesfői0Róbert Herczeg1Zoltán Lőcsei2Klára Sebestyén3Zsolt Sebestyén4László Mangel5Miklós Damásdi6Lab-on-a-Chip Research Group, János Szentágothai Research Center, University of Pécs, H-7624 Pécs, Ifjúság útja 20, HungaryBioinformatics Research Group, Genomic and Bioinformatics Core Facility, János Szentágothai Research Center, University of Pécs, H-7624 Pécs, Ifjúság útja 20, HungaryDepartment of Oncotherapy, Clinical Centre, Medical School, University of Pécs, H-7624 Pécs, Édesanyák útja 10, HungaryDepartment of Oncotherapy, Clinical Centre, Medical School, University of Pécs, H-7624 Pécs, Édesanyák útja 10, HungaryDepartment of Oncotherapy, Clinical Centre, Medical School, University of Pécs, H-7624 Pécs, Édesanyák útja 10, HungaryDepartment of Oncotherapy, Clinical Centre, Medical School, University of Pécs, H-7624 Pécs, Édesanyák útja 10, HungaryUrology Clinic, Clinical Centre, Medical School, University of Pécs, H-7621 Pécs, Munkácsy Mihály utca 2, HungaryBackground: Radiation therapy has undergone significant technical development in the past decade. However, the complex therapy of intermediate-risk patients with organ-confined prostate carcinoma still poses many questions. Our retrospective study investigated the impact of selected components of the treatment process including radiotherapy, hormone deprivation, risk classification, and patients’ response to therapy. Methods: The impact of delivered dose, planning accuracy, duration of hormone deprivation, risk classification, and the time to reach prostate-specific antigen (PSA) nadir state were analyzed among ninety-nine individuals afflicted with organ-confined disease. Progression was defined as a radiological or biochemical relapse within five years from radiotherapy treatment. Results: We found that 58.3% of the progressive population consisted of intermediate-risk patients. The progression rate in the intermediate group was higher (21.9%) than in the high-risk population (12.1%). Dividing the intermediate group, according to the International Society of Urological Pathology (ISUP) recommendations, resulted in the non-favorable subgroup having the highest rate of progression (33.3%) and depicting the lowest percentage of progression-free survival (66.7%). Conclusion: Extended pelvic irradiation on the regional lymph nodes may be necessary for the ISUP Grade 3 subgroup, similarly to the high-risk treatment. Therapy optimization regarding the intermediate-risk population based on the ISUP subgrouping suggestions is highly recommended in the treatment of organ-confined prostate cancer.https://www.mdpi.com/2077-0383/10/1/110prostate cancerradiotherapyandrogen deprivation therapytherapy optimization |
| spellingShingle | Viktória Temesfői Róbert Herczeg Zoltán Lőcsei Klára Sebestyén Zsolt Sebestyén László Mangel Miklós Damásdi Should We Reconsider the Necessity of a Refinement of Prostate Cancer Risk Classification and Radiotherapy Treatment Strategy? Experiences from a Retrospective Analysis of Data from a Single Institution Journal of Clinical Medicine prostate cancer radiotherapy androgen deprivation therapy therapy optimization |
| title | Should We Reconsider the Necessity of a Refinement of Prostate Cancer Risk Classification and Radiotherapy Treatment Strategy? Experiences from a Retrospective Analysis of Data from a Single Institution |
| title_full | Should We Reconsider the Necessity of a Refinement of Prostate Cancer Risk Classification and Radiotherapy Treatment Strategy? Experiences from a Retrospective Analysis of Data from a Single Institution |
| title_fullStr | Should We Reconsider the Necessity of a Refinement of Prostate Cancer Risk Classification and Radiotherapy Treatment Strategy? Experiences from a Retrospective Analysis of Data from a Single Institution |
| title_full_unstemmed | Should We Reconsider the Necessity of a Refinement of Prostate Cancer Risk Classification and Radiotherapy Treatment Strategy? Experiences from a Retrospective Analysis of Data from a Single Institution |
| title_short | Should We Reconsider the Necessity of a Refinement of Prostate Cancer Risk Classification and Radiotherapy Treatment Strategy? Experiences from a Retrospective Analysis of Data from a Single Institution |
| title_sort | should we reconsider the necessity of a refinement of prostate cancer risk classification and radiotherapy treatment strategy experiences from a retrospective analysis of data from a single institution |
| topic | prostate cancer radiotherapy androgen deprivation therapy therapy optimization |
| url | https://www.mdpi.com/2077-0383/10/1/110 |
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