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Primary Gleason Pattern Does Not Affect Recurrence-Free Survival in Patients Receiving Radiotherapy for Prostate Cancer

Abstract

Tadahiko Kikugawa, Nozomu Tanji, Noriyoshi Miura, Takashi Ochi, Atsushi Nishikawa, Yuki Miyauchi, Takeshi Sato, Hitoshi Hamada, Atsushi Matsumoto and Masayoshi Yokoyama

Objective: To evaluate biochemical recurrence-free survival (b-RFS) in patients with Gleason score 7 prostate cancers treated with external beam radiotherapy at Ehime University Hospital. Materials and Methods: Between January 2003 and October 2009, 63 patients with Gleason score 7 prostate cancers were treated with three-dimensional conformal radiotherapy (3D-CRT) at our institute. Of the 63 patients analyzed, 41 and 22 had a primary Gleason pattern of 3 and 4 carcinoma, respectively. Neoadjuvant hormonal therapy had been given to 37 patients (59%) for 6 months prior to radiotherapy. The American Society for Therapeutic Radiology and Oncology Phoenix consensus definition was used to determine the b-RFS after treatment. Results: The overall b-RFS rate at 5 year was 71% and 77% for Gleason score 3+4 and 4+3 prostate cancer, respectively. The overall b-RFS at 5 year was 59% and 86% in Gleason score 3+4 patients with and without neoadjuvant hormonal therapy for 6 months, respectively. Conclusions: Our results indicate that the 5 year b-RFS outcome with 3D-CRT is not dependent on Gleason score 3+4 versus 4+3 histological features, or on neoadjuvant hormonal therapy for 6 months in patients with a Gleason score of 3+4.

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