Efficacy and toxicity of intensity-modulated radiation therapy for prostate cancer in Chinese patients

Objective To report the treatment efficacy and toxicity profile of intensity-modulated radiation therapy in Chinese patients with clinically localised prostate cancer. Design Historical cohort study. Setting Oncology unit in a university teaching hospital in Hong Kong. Patients Patients with clinically localised prostate cancer undergoing intensity-modulated radiation therapy in our institution between May 2001 and November 2009 were reviewed. Main outcome measures The 5-year biochemical failure-free survival, 5-year overall survival, as well as acute/late gastro-intestinal toxicities and genito-urinary toxicities. Results A total of 182 patients were treated with prostate intensity-modulated radiation therapy with or without whole-pelvic radiotherapy. The median follow-up was 44 months. The median patient age was 72 years. Overall survival of the cohort was 92% after 5 years. The favourable, intermediate, and unfavourable risk category distributions of the National Comprehensive Cancer Network were 21(12%), 42 (23%), and 119 (65%), respectively. The 5-year actuarial biochemical failure-free survival rates for patients in these categories were 95%, 82%, and 80%, respectively. Multivariate analysis identified early tumour stage, low pre-treatment prostate-specific antigen levels, and the use of adjuvant androgen deprivation as independent prognostic factors for better biochemical failure free survival. Grade 2 and 3 late gastro-intestinal/genito-urinary toxicities occurred in 8%/3% and 4%/3% of the patients, respectively. Conclusion Intensity-modulated radiation therapy for prostate cancer is feasible and safe in the Chinese population. These data are consistent with the results of other series in Caucasian populations.