The biochemical efficacy of primary cryoablation combined with prolonged total androgen suppression compared with radiotherapy on high-risk prostate cancer

A 3-year pilot study

Young Hwii Ko, Seok Ho Kang, Young Je Park, Hong Seok Park, Du Geon Moon, Jeong Gu Lee, Duck Ki Yoon, Je-Jong Kim, Jun Cheon

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

To gain beneficial effects in the management of high-risk prostate cancer, an integrated approach that combines local therapy and androgen deprivation therapy (ADT) was used. We compared biochemical responses between primary cryosurgical ablation of the prostate (CSAP) combined with prolonged ADT and radiation combined with ADT, which is the established modality in high-risk disease. A total of 33 high-risk patients received CSAP combined with ADT for 3 months before and up to 24 months after treatment. This patient group was matched with another 33 patients who had undergone three-dimensional conformal radiation therapy (3D-CRT) with the same protocol for ADT. Biochemical recurrence (BCR) was assessed by the American Society for Therapeutic Radiation Oncology (ASTRO) definition, the Phoenix definition and a prostate-specific antigen (PSA) cutoff of 0.5 ng mL 1. Median follow-up was 61.0± 11.9 months for the CSAP + ADT group and 86.0± 15.8 months for the 3D-CRT + ADT group. In the CSAP group, major complications including rectourethral fistula and incontinence were not noted. In the CSAP + ADT group, 57.0% had BCR using the ASTRO definition, 21.2% using the Phoenix definition and 54.5% using a PSA cutoff of 0.5 ng mL -1. In the 3D-CRT + ADT group, 54.5%, 21.2% and 54.5% had BCR using the ASTRO, Phoenix and PSA definition, respectively. In the CSAP + ADT group, the BCR-free survival (BRFS) was 54 10 months using the ASTRO definition, 65± 5 months using the Phoenix definition and 51 ± 4 months using a PSA cutoff of 0.5 ng mL -1. In the 3D-CRT + ADT group, the BRFS was 68 ± 12, 93 ± 19 and 70 ± 18 months using the ASTRO, Phoenix and PSA definition, respectively. By the log-rank test, the BRFS values for each group were not statistically different. This intermediate-term result indicated that primary CSAP combined with prolonged ADT offers a parallel biochemical response compared with radiotherapy in high-risk prostate cancer.

Original languageEnglish
Pages (from-to)827-834
Number of pages8
JournalAsian Journal of Andrology
Volume12
Issue number6
DOIs
Publication statusPublished - 2010 Nov 1

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Cryosurgery
Androgens
Prostatic Neoplasms
Radiotherapy
Group Psychotherapy
Radiation Oncology
Prostate
Prostate-Specific Antigen
Therapeutics
Recurrence
Survival
Risk Management
Fistula
Research Design

Keywords

  • Androgen ablation therapy
  • cryoablation for the prostate
  • radiotherapy

ASJC Scopus subject areas

  • Urology

Cite this

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title = "The biochemical efficacy of primary cryoablation combined with prolonged total androgen suppression compared with radiotherapy on high-risk prostate cancer: A 3-year pilot study",
abstract = "To gain beneficial effects in the management of high-risk prostate cancer, an integrated approach that combines local therapy and androgen deprivation therapy (ADT) was used. We compared biochemical responses between primary cryosurgical ablation of the prostate (CSAP) combined with prolonged ADT and radiation combined with ADT, which is the established modality in high-risk disease. A total of 33 high-risk patients received CSAP combined with ADT for 3 months before and up to 24 months after treatment. This patient group was matched with another 33 patients who had undergone three-dimensional conformal radiation therapy (3D-CRT) with the same protocol for ADT. Biochemical recurrence (BCR) was assessed by the American Society for Therapeutic Radiation Oncology (ASTRO) definition, the Phoenix definition and a prostate-specific antigen (PSA) cutoff of 0.5 ng mL 1. Median follow-up was 61.0± 11.9 months for the CSAP + ADT group and 86.0± 15.8 months for the 3D-CRT + ADT group. In the CSAP group, major complications including rectourethral fistula and incontinence were not noted. In the CSAP + ADT group, 57.0{\%} had BCR using the ASTRO definition, 21.2{\%} using the Phoenix definition and 54.5{\%} using a PSA cutoff of 0.5 ng mL -1. In the 3D-CRT + ADT group, 54.5{\%}, 21.2{\%} and 54.5{\%} had BCR using the ASTRO, Phoenix and PSA definition, respectively. In the CSAP + ADT group, the BCR-free survival (BRFS) was 54 10 months using the ASTRO definition, 65± 5 months using the Phoenix definition and 51 ± 4 months using a PSA cutoff of 0.5 ng mL -1. In the 3D-CRT + ADT group, the BRFS was 68 ± 12, 93 ± 19 and 70 ± 18 months using the ASTRO, Phoenix and PSA definition, respectively. By the log-rank test, the BRFS values for each group were not statistically different. This intermediate-term result indicated that primary CSAP combined with prolonged ADT offers a parallel biochemical response compared with radiotherapy in high-risk prostate cancer.",
keywords = "Androgen ablation therapy, cryoablation for the prostate, radiotherapy",
author = "Ko, {Young Hwii} and Kang, {Seok Ho} and Park, {Young Je} and Park, {Hong Seok} and Moon, {Du Geon} and Lee, {Jeong Gu} and Yoon, {Duck Ki} and Je-Jong Kim and Jun Cheon",
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T1 - The biochemical efficacy of primary cryoablation combined with prolonged total androgen suppression compared with radiotherapy on high-risk prostate cancer

T2 - A 3-year pilot study

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AU - Kang, Seok Ho

AU - Park, Young Je

AU - Park, Hong Seok

AU - Moon, Du Geon

AU - Lee, Jeong Gu

AU - Yoon, Duck Ki

AU - Kim, Je-Jong

AU - Cheon, Jun

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N2 - To gain beneficial effects in the management of high-risk prostate cancer, an integrated approach that combines local therapy and androgen deprivation therapy (ADT) was used. We compared biochemical responses between primary cryosurgical ablation of the prostate (CSAP) combined with prolonged ADT and radiation combined with ADT, which is the established modality in high-risk disease. A total of 33 high-risk patients received CSAP combined with ADT for 3 months before and up to 24 months after treatment. This patient group was matched with another 33 patients who had undergone three-dimensional conformal radiation therapy (3D-CRT) with the same protocol for ADT. Biochemical recurrence (BCR) was assessed by the American Society for Therapeutic Radiation Oncology (ASTRO) definition, the Phoenix definition and a prostate-specific antigen (PSA) cutoff of 0.5 ng mL 1. Median follow-up was 61.0± 11.9 months for the CSAP + ADT group and 86.0± 15.8 months for the 3D-CRT + ADT group. In the CSAP group, major complications including rectourethral fistula and incontinence were not noted. In the CSAP + ADT group, 57.0% had BCR using the ASTRO definition, 21.2% using the Phoenix definition and 54.5% using a PSA cutoff of 0.5 ng mL -1. In the 3D-CRT + ADT group, 54.5%, 21.2% and 54.5% had BCR using the ASTRO, Phoenix and PSA definition, respectively. In the CSAP + ADT group, the BCR-free survival (BRFS) was 54 10 months using the ASTRO definition, 65± 5 months using the Phoenix definition and 51 ± 4 months using a PSA cutoff of 0.5 ng mL -1. In the 3D-CRT + ADT group, the BRFS was 68 ± 12, 93 ± 19 and 70 ± 18 months using the ASTRO, Phoenix and PSA definition, respectively. By the log-rank test, the BRFS values for each group were not statistically different. This intermediate-term result indicated that primary CSAP combined with prolonged ADT offers a parallel biochemical response compared with radiotherapy in high-risk prostate cancer.

AB - To gain beneficial effects in the management of high-risk prostate cancer, an integrated approach that combines local therapy and androgen deprivation therapy (ADT) was used. We compared biochemical responses between primary cryosurgical ablation of the prostate (CSAP) combined with prolonged ADT and radiation combined with ADT, which is the established modality in high-risk disease. A total of 33 high-risk patients received CSAP combined with ADT for 3 months before and up to 24 months after treatment. This patient group was matched with another 33 patients who had undergone three-dimensional conformal radiation therapy (3D-CRT) with the same protocol for ADT. Biochemical recurrence (BCR) was assessed by the American Society for Therapeutic Radiation Oncology (ASTRO) definition, the Phoenix definition and a prostate-specific antigen (PSA) cutoff of 0.5 ng mL 1. Median follow-up was 61.0± 11.9 months for the CSAP + ADT group and 86.0± 15.8 months for the 3D-CRT + ADT group. In the CSAP group, major complications including rectourethral fistula and incontinence were not noted. In the CSAP + ADT group, 57.0% had BCR using the ASTRO definition, 21.2% using the Phoenix definition and 54.5% using a PSA cutoff of 0.5 ng mL -1. In the 3D-CRT + ADT group, 54.5%, 21.2% and 54.5% had BCR using the ASTRO, Phoenix and PSA definition, respectively. In the CSAP + ADT group, the BCR-free survival (BRFS) was 54 10 months using the ASTRO definition, 65± 5 months using the Phoenix definition and 51 ± 4 months using a PSA cutoff of 0.5 ng mL -1. In the 3D-CRT + ADT group, the BRFS was 68 ± 12, 93 ± 19 and 70 ± 18 months using the ASTRO, Phoenix and PSA definition, respectively. By the log-rank test, the BRFS values for each group were not statistically different. This intermediate-term result indicated that primary CSAP combined with prolonged ADT offers a parallel biochemical response compared with radiotherapy in high-risk prostate cancer.

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