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Long-term Results of External Beam Radiotherapy for Prostate Cancer with Prostate-specific Antigen of More Than 50 ng/ml and Without Evidence of Lymph Node or Distant Metastasis.

BACKGROUND/AIM: To evaluate long-term treatment outcomes of external beam radiotherapy for prostate cancer with a pretreatment prostate-specific antigen (PSA) level of more than 50 ng/ml and without evidence of lymph node or distant metastasis.

PATIENTS AND METHODS: Definitive radiotherapy of 66 Gy or 72 Gy in combination with androgen deprivation therapy (ADT) was performed. PSA relapse-free survival (PRFS), distant metastasis-free survival (DMFS), cause-specific survival (CSS), and overall survival (OS) were evaluated. The impact of prognostic factors on PRFS, DMFS, CSS, and OS was analyzed in univariate and multivariate analyses.

RESULTS: One hundred twenty patients with a median follow-up period of 92.6 months were analyzed in this study. The median duration of ADT was 11.0 months. The 5- and 8-year PRFS rates in all patients were 65.1% and 48.5%, respectively. The 8-year DMFS, CSS, and OS rates in all patients were 84.0%, 93.4%, and 81.6%, respectively. Both in univariate and multivariate analyses, Gleason score (GS) and radiotherapy dose were significant prognostic factors (p=0.015 and 0.001). There was no significant difference between each prognostic factor in DMFS, CSS, and OS.

CONCLUSION: We might have indicated the significance of definitive radiotherapy even for prostate cancer with PSA of more than 50 ng/ml and without evidence of metastasis.

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