Impact of Androgen Deprivation Therapy Associated to Conformal Radiotherapy in the Treatment of D'Amico Intermediate-/High-Risk Prostate Cancer in Older Patients.
PURPOSE/OBJECTIVE
The association of 3D Conformal External Beam Radiotherapy (3D-CEBRT) with adjuvant Androgen Deprivation Therapy (ADT) proved to treat patients with intermediate- and high-risk localized prostate cancer (IR and HR). However, older patients were underrepresented in literature. We aimed to report the oncological results and morbidity 3D-CEBRT +ADT in ≥80 years patients.


MATERIAL AND METHODS
From June 1998 to July 2017, 101 patients ≥80 years were included in a tertiary center. The median age was 82 years. ADT was initiated 3 months prior 3D-CEBRT in all patients, with a total duration of 6 months for IR prostate cancer (group A; n = 41) and 15 months for HR prostate cancer (group B; n = 60). Endpoints included overall survival (OS), metastasis-free survival (DMFS), biochemical recurrence-free survival (BRFS) and toxicity.


RESULTS
Five years-OS was 95% and 86.7% in groups A and B, respectively. Cardiovascular events occurred in 22.8% of ≥80 years patients with no impact on OS. In the multivariate analysis, age <82 years, Karnofsky index and normalization of testosterone levels were significantly associated with better OS.


CONCLUSION
Age ≥80 years should not be a limitation for the treatment of IR and HR prostate cancer patients with 3D-CEBRT and ADT, but cardiovascular monitoring and prevention are mandatory.
['Couderc|Anne-Laure|AL|0000-0003-2938-2201', 'Nicolas|Emanuel|E|', 'Boissier|Romain|R|', 'Boucekine|Mohammed|M|', 'Bastide|Cyrille|C|', 'Badinand|Delphine|D|', 'Rossi|Dominique|D|', 'Mugnier|Benedicte|B|', 'Villani|Patrick|P|', 'Karsenty|Gilles|G|', 'Cowen|Didier|D|', 'Lechevallier|Eric|E|', 'Muracciole|Xavier|X|']
androgen deprivation therapy 3D conformal external beam radiotherapy localized prostate cancer older adults