Objective of the study: To evaluate the long-term outcomes of localized prostate cancer patients treated with radiotherapy (RT) in the department of clinical oncology, Souhag Faculty of Medicine, Souhag Cancer Institute and, Souhag Health Insurance Hospital in the Governorate of Souhag, Egypt.
MATERIALS AND METHODS: All diagnosed non metastatic prostate cancer patients treated with RT as primary therapy or after surgery (adjuvant) with and without hormonal therapy (HT) between August 1998 and December 2013 in the localities stated above were allocated.
RESULTS: One hundred forty two patients were identified, 116 (82%) received primary radiotherapy (primary RT). Twenty six patients received RT either as an adjuvant RT or salvage RT (21 and 5 patients respectively). Hormonal treatment was given to 60 (42%) patients. The median age of the patients was 68 yr. The
median follow up period was 36 months. The patients were classified into three risk groups based on the tumor stage, serum PSA and Gleason score. During the follow up period, 26 patients developed biochemical failure (BF). Analysis of the median biochemical failure free survival (BFFS) revealed that, the type of radiotherapy was the only one predictive factor affecting this outcome (p=0.001). Subgroup analysis showed significant survival advantage of adjuvant RT over salvage one (p=0.04). Eleven patients, developed distant failures. Only the age of patients younger than 65 yr was significantly associated with better distant failure free survival (p = 0.027). Severe acute and chronic rectal toxicities were reported in 57 (40%) and 30 patients (21%) respectively. For urinary toxicities, 96 patients (68%) and 24 ones (17%) suffered from severe acute and chronic morbidities. Age older than 65 yr was the only predictive risk factor for the development of such toxicities (p = 0.04).
CONCLUSIONS: Precautionary RT that is given after surgical treatment of localized cancer prostate is superior than salvage one given after development of BF in terms of BFFS. And more advanced RT techniques are required to have less treatment related morbidities.