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Does Radiotherapy for the Primary Tumor Benefit Prostate Cancer Patients with Distant Metastasis at Initial Diagnosis?

 Yeona Cho  ;  Jee Suk Chang  ;  Koon Ho Rha  ;  Sung Joon Hong  ;  Young Deuk Choi  ;  Won Sik Ham  ;  Jun Won Kim  ;  Jaeho Cho 
 PLoS One, Vol.11(1) : e014791, 2016 
Journal Title
 PLoS One 
Issue Date
Adenocarcinoma/radiotherapy ; Adenocarcinoma/secondary* ; Aged ; Androgens* ; Antineoplastic Agents, Hormonal/adverse effects ; Bone Neoplasms/pathology ; Bone Neoplasms/secondary ; Disease-Free Survival ; Humans ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Neoplasm Staging ; Neoplasms, Hormone-Dependent/pathology ; Neoplasms, Hormone-Dependent/radiotherapy* ; Organs at Risk ; Prognosis ; Prostatic Neoplasms/pathology ; Prostatic Neoplasms/radiotherapy* ; Radiotherapy/adverse effects ; Soft Tissue Neoplasms/pathology ; Soft Tissue Neoplasms/secondary ; Treatment Outcome
PURPOSE/OBJECTIVES: Treatment of the primary tumor reportedly improves survival in several types of metastatic cancer. We herein evaluated the efficacy and toxicity of radiotherapy for the primary tumor in prostate cancer with metastasis. MATERIALS/METHODS: The study cohort included 140 men with metastatic prostate cancer at initial diagnosis. Metastatic sites were divided into 4 groups as follows: solitary bone, 2-4 bones, ≥5 bones, and visceral organs. Patient, tumor, and treatment characteristics, and clinical outcomes were compared between patients treated with (prostate radiotherapy [PRT] group) or without radiotherapy to the primary tumor. RESULTS: Patients in PRT group presented with a statistically significantly younger age (p = .02), whereas other characteristics showed no significant difference. Overall survival (OS) and biochemical failure-free survival (BCFFS) were improved in PRT patients (3-year OS: 69% vs. 43%, p = 0.004; 3-year BCFFS: 52% vs. 16%, p = 0.002). Multivariate analysis identified PRT as a significant predictor of both OS (hazard ratio [HR] = 0.43, p = 0.015). None of the 38 PRT patients experienced severe (grade ≥3) genitourinary or gastrointestinal toxicity. CONCLUSIONS: Our data suggest that radiotherapy to the primary tumor was associated with improved OS and BCFFS in metastatic prostate cancer. The results of this study warrant prospective controlled clinical trials of this approach in stage IV prostate cancer patients with limited extent of bone metastasis and good performance status.
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1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실) > 1. Journal Papers
Yonsei Authors
김준원(Kim, Jun Won) ORCID logo https://orcid.org/0000-0003-1358-364X
나군호(Rha, Koon Ho) ORCID logo https://orcid.org/0000-0001-8588-7584
장지석(Chang, Jee Suk Paul) ORCID logo https://orcid.org/0000-0001-7685-3382
조연아(Cho, Yeona) ORCID logo https://orcid.org/0000-0002-1202-0880
조재호(Cho, Jae Ho) ORCID logo https://orcid.org/0000-0001-9966-5157
최영득(Choi, Young Deuk) ORCID logo https://orcid.org/0000-0002-8545-5797
함원식(Ham, Won Sik) ORCID logo https://orcid.org/0000-0003-2246-8838
홍성준(Hong, Sung Joon) ORCID logo https://orcid.org/0000-0001-9869-065X
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