Early toxicity of combined treatment in localised and locally advanced prostate cancer:
hormone therapy with conformal radiotherapy
Article published in Urologia Polska 2002/55/2.
Piotr Milecki 1, Grażyna Stryczyńska 1, Tomasz Stachowski 2, Zbigniew Kwias 2
- 1 Department of Radiotherapy, Wielkopolskie Cancer Centre, Poznań, Poland, Head of the Department: Grażyna Stryczyńska, PhD, MD.
2 Chair of Urology, University School of Medical Sciences, Poznań, Poland, Chair of Urology: Zbigniew Kwias, PhD, MD
prostate - prostate cancer, radiotherapy i hormone therapy, acute morbidity
- Purpose: to evaluate acute toxicity of combined treatment (androgen ablation and 3D confomial radiotherapy [3D-CRT]) in patients with localised and locally advanced cancer of the prostate.
- Materials and methods. Between April 1999 and December 2000, at the Wielkopolskie Cancer Centre in Poznań, 42 patients with prostate cancer (T1-T3 NO MO) were treated with 3 D conformal radiation therapy and hormone therapy. Patients represented a localised disease (1=4 patients, T2 = 11 patients) and locally advanced disease (T3 = 27 patients). No patients had clinically detectable distant metastases. Neoadjuvant androgen ablation therapy (LH-RH agonists or bilateral orchidectomy and flutamide) was given to all patients. Radiotherapy was performed using 15 MV photons in the daily fraction of 1.8 Gy to the total median dose of 71.7 Gy (range, 67.8 to 72 Gy). Acute toxicities were evaluated according to the Radiation Therapy Oncology Group (RTOG) morbidity scoring scale.
- Results. All patients completed the entire course of radiotherapy and were assessable for evaluation of acute toxicities. The most common side effects of androgen ablation were „hot flushes\", gynaecomastia, and slight discomfort in the abdomen, although these were of mild intensity. The main problems during irradiation and for a few weeks after the completion of radiotherapy were related to:
- genito-urinary tract (rgency, nocturia, dysuria). Toxicities were as follow: grade 0 and 1: 80% of patients and grade 2: 20% of patients,
- - gastro-inlestinal tract (ectal discomfort and mild diarrhoea). Toxicities were as follow: grade 0 and 1: 75% of patients and grade 2: 25% of patients.
- Conclusions. Preliminary results of combined treatment (androgen ablation and 3- D CRT) suggested that such modality is well tolerated with only modest acute toxicities of gastro-intestinal and genito-urinary tract.
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