Efficacy and toxicity of intensity-modulated radiation therapy for prostate cancer in Chinese patients

Hong Kong Med J. 2013 Oct;19(5):407-15. doi: 10.12809/hkmj133815.

Abstract

Objective: To report the treatment efficacy and toxicity profile of intensitymodulated radiation therapy in Chinese patients with clinically localised prostate cancer.

Design: Historical cohort study.

Setting: Oncology unit in a university teaching hospital in Hong Kong.

Patients: Patients with clinically localised prostate cancer undergoing intensity-modulated radiation therapy in our institution between May 2001 and November 2009 were reviewed.

Main outcome measures: The 5-year biochemical failure–free survival, 5-year overall survival, as well as acute/late gastro-intestinal toxicities and genito-urinary toxicities.

Results: A total of 182 patients were treated with prostate intensitymodulated radiation therapy with or without whole-pelvic radiotherapy. The median follow-up was 44 months. The median patient age was 72 years. Overall survival of the cohort was 92% after 5 years. The favourable, intermediate, and unfavourable risk category distributions of the National Comprehensive Cancer Network were 21 (12%), 42 (23%), and 119 (65%), respectively. The 5-year actuarial biochemical failure–free survival rates for patients in these categories were 95%, 82%, and 80%, respectively. Multivariate analysis identified early tumour stage, low pre-treatment prostate-specific antigen levels, and the use of adjuvant androgen deprivation as independent prognostic factors for better biochemical failure–free survival. Grade 2 and 3 late gastro-intestinal/genito-urinary toxicities occurred in 8%/3% and 4%/3% of the patients, respectively.

Conclusion: Intensity-modulated radiation therapy for prostate cancer is feasible and safe in the Chinese population. These data are consistent with the results of other series in Caucasian populations.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Disease-Free Survival
  • Feasibility Studies
  • Follow-Up Studies
  • Gastrointestinal Diseases / epidemiology
  • Gastrointestinal Diseases / etiology
  • Hong Kong
  • Hospitals, University
  • Humans
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Prognosis
  • Prostate-Specific Antigen / blood*
  • Prostatic Neoplasms / pathology
  • Prostatic Neoplasms / radiotherapy*
  • Radiotherapy, Intensity-Modulated / adverse effects
  • Radiotherapy, Intensity-Modulated / methods*
  • Retrospective Studies
  • Survival Rate
  • Time Factors
  • Treatment Outcome
  • Urogenital System / radiation effects

Substances

  • Prostate-Specific Antigen