Background:Hormone therapy is commonly used with radiotherapy in the treatment of prostate cancer. Aim:To provide a single-institution analysis of the benefits of hormone therapy with radiotherapy in different non-metastatic prostate cancer scenarios. Methods:The records of 527 patients receiving radiotherapy for locally advanced, localized, and post-prostatectomy disease were reviewed. For the 422 patients with localized disease, biochemical failure-free survival curves were generated for patients receiving or not receiving hormone therapy (with biochemical failure defined as three successive rises after prostate-specific antigen nadir). The survival curves were compared using the log-rank test and a multivariate analysis of all major patient, disease, and treatment factors was performed. Additionally, failure rates were compared using the chi-square test to determine the benefit of hormone therapy across each of the locally advanced, localized, and post-prostatectomy settings. Results:An advantage for the use of hormone therapy compared with radiotherapy alone was observed in the population with localized disease (3-year biochemical failure-free survival 78% vs 75%; p = 0.029). Of the patient, disease, and treatment factors analyzed, only clinical T-stage (p = 0.002), radiation dose (p = 0.006), and hormone therapy (p = 0.016) reached statistical significance on multivariate analysis. Furthermore, lower failure rates occured (with at least a trend observed [p < 0.10]) in patients receiving hormone therapy in each clinical scenario, with the exception of the localized low-risk subgroup. Conclusion:In a single-institution analysis, the addition of hormone therapy to radiotherapy was advantageous in all settings of non-metastatic prostate cancer except that of the very earliest disease presentation.
American Journal of Cancer – Springer Journals
Published: Aug 10, 2012