Moderate hypofractionated radiotherapy after prostatectomy for cancer patients: toxicity and clinical outcome

Figures & data

Table 1 Main characteristics of the patients analyzed

Patient characteristic	All Patients	RT	RT+HT	P-value
Number of patients (%)	64	33 (51.5)	31 (48.5)
Number of deaths (%)	2	0 (0.0)	2 (6.5)
Age at surgery, mean (SD)	64.9	64.7 (6.8)	64.2 (8.2)	0.995
Gleason score >7, N (%)	27 (42.2)	9 (27.3)	18 (58.1)	0.013
PSA levels before surgery, ng/mL, mean (SD)	11.9	8.9 (5.5)	11.8 (6.7)	0.047
Comorbidity (<1), N (%)a	25	11 (33.3)	14 (45.2)	0.332
Positive lymph nodes (≥1), N (%)	16	0 (0.0)	16 (51.6)	<0.0001

Notes:

a Cardiovascular disease, arterial hypertension, bowel disease, diabetes mellitus.

Abbreviations: HT, hormonal therapy; PSA, prostate-specific antigen; RT, radiotherapy.

Figure 1 Kaplan–Meier toxicity-free survival estimates.

Notes: (A) Late toxicity-free survival in the overall population; (B) late toxicity-free survival stratified for treatment received (RT, black line vs RT+HT, gray line); (C) acute toxicity-free survival in the overall population; (D) acute toxicity-free survival stratified for treatment received (RT, black line vs RT+HT, gray line).

Abbreviations: HT, hormonal therapy; RT, radiotherapy.

Table 2 Multivariate analysis (Cox model) for acute toxicity

Covariate	HR	SE	z	p>z	95% Confidence interval
RT+HT	0.382	0.385	–0.95	0.340	0.053–2.752
1+ Comorbidities	0.913	0.742	–0.11	0.910	0.185–4.495
Gleason score >8	0.206	0.180	–1.81	0.070	0.037–1.140
1+ Positive lymph nodes	19.897	24.661	2.41	0.016	1.753–225.81
RT-salvage	3.696	2.624	1.84	0.066	0.919–14.861
Pre-RT PSA	1.433	0.281	1.83	0.067	0.975–2.104
Presurgery PSA	1.066	0.041	1.68	0.094	0.989–1.150
Age	1.018	0.042	0.43	0.665	0.939–1.103
Pelvic RT	9.427	10.835	1.95	0.051	0.990–89.689

Abbreviations: HR, hazard ratio; HT, hormonal therapy; PSA, prostate-specific antigen; RT, radiotherapy; SE, standard error of the mean.

Table 3 Multivariate analysis (Cox model) for late toxicity

Covariate	HR	SE	z	p>z	95% confidence interval
RT+HT	9.722	33.238	0.67	0.506	0.011–7903.112
1+ Comorbidities	0.036	0.065	–1.85	0.064	0.001–1.206
Gleason score >8	0.032	0.048	–2.26	0.024	0.001–0.636
1+ Positive lymph nodes	5.565	19.662	0.49	0.627	0.005–5655.815
RT-salvage	0.0157	0.058	–1.13	0.260	0.00001–21.735
Pre-RT PSA	0.138	0.218	–1.25	0.210	0.006–3.048
Presurgery PSA	1.135	0.095	1.51	0.131	0.962–1.340
Age	1.169	0.099	1.83	0.067	0.988–1.382

Abbreviations: HR, hazard ratio; HT, hormonal therapy; PSA, prostate-specific antigen; RT, radiotherapy; SE, standard error of the mean.

Figure 2 Kaplan–Meier survival estimates in the overall population (A), or stratified for: (B) treatment received (RT, black line vs RT+HT, gray line); (C) presence of at least one positive lymph node (0, black line vs 1+, gray line); (D) PSA value (<10, black line vs ≥10, gray line).

Abbreviations: HT, hormonal therapy; PSA, prostate-specific antigen; RT, radiotherapy.