Improving the efficiency of treatment for stages III—IV prostate cancer

Abstract

Objective: to evaluate the efficiency of various therapeutic modalities in patients with Stages III, IV prostate cancer (PC) concurrent with local hyperthermia (LH).

Materials and methods. The results of treatment were analyzed in 895 PC patients; out of them 743 had Stages III (49.9%) and IV (33.1%). The following treatments were performed: radiation, hormonal, hormonoradiation, and hormonoradiation treatment with thermoradiomodification. Therapeutic efficiency was evaluated by the cumulative cancer-specific survival rates.

Results. In the patients with Stage III PC receiving multimodality treatment, 5-year survival was 66.1%. In the group of patients where thermoradiomodification was added the survival reached 76.7%. Patients treated with radiotherapy and hormonotherapy had a survival rate of 60.4 and 55.2%, respectively. By year 10 of a follow-up, the survival rates were 47.9% in the hormonotherapy group and 42.5% in the hormonoradiotherapy group. In patients with locally advanced Stage IV PC, 5-year survival was 68.5, 66.4, and 52.9% after hormonoradiation therapy, radiotherapy, and hormonotherapy, respectively. The patients receiving treatment with thermoradiomodification fail to survive up to 5 years. 10-year cancer-specific survival following hormonoradiotherapy and hormonotherapy was 27.1 and 13.2%, respectively. In the patients with metastatic PC who had hormonotherapy, radiotherapy, complex treatment without and with thermoradiomodification, 5-year survival was 51.0, 45.3, 35.6, and 0%, respectively. As high as 7.7% of the patients, who have received hormonal therapy, survived up to 10 years.

Conclusion. Multimodality treatment is most effective in the management of Stages III and IV PC. Thermoradiomodification significantly improves the results of treatment for Stage III, but it should not be applied to patients with Stage IV. Radiotherapy is more effective in the first years of life, but further its efficiency becomes less. Hormonotherapy is most beneficial in disseminated cancer.