Evaluation of endocrine therapy combined with intensity modulated radiation therapy in patients with advanced prostate cancer

Abstract

Abstract Objective The aim of this study was to study the effect of endocrine therapy combined with intensity-modulated radiation therapy in patients with advanced prostate cancer. Methods The clinical data of 231 patients with advanced prostate cancer treated with radiotherapy in our hospital from May 2010 to March 2018 were collected. A total of 135 patients were treated with endocrine therapy combined with intensity-modulated radiotherapy, and 96 patients were treated with intensity-modulated radiotherapy only because of drug allergy, serious adverse reactions, and economic reasons. Two months after the end of the treatment, the short-term curative effect was evaluated using imaging reexamination. The total prostate-specific antigen (TPSA) and free prostate-specific antigen (FPSA) were detected before and 2 months after the end of the treatment. All patients were followed up for at least 3 years, and the metastasis-free survival rate and cumulative survival rate of the two groups were calculated. Results The remission rates (RRs) of the observation and control groups were 64.45% and 46.87%, respectively; the difference was not statistically significant (P > 0.05); however, the efficacy distribution of the endocrine therapy combined with intensity-modulated radiotherapy group was significantly better than that of the intensity-modulated radiotherapy group (P < 0.05). There was no significant difference in clinical efficacy between the two groups in different TNM stages and Gleason grades. After treatment, the levels of TPSA and FPSA were significantly decreased compared with those before treatment; however, the decrease in the endocrine therapy combined with the intensity-modulated radiation therapy (IMRT) group was significantly higher than that in the IMRT group (P < 0.05). Although there were no significant differences in the 1-year and 3-year cumulative survival rates between the two groups, the 1-year and 3-year metastasis-free survival rates of the endocrine therapy combined with the IMRT group were 60% and 38.17%, respectively, which were significantly higher than those of the IMRT group (37.5% and 20.83%, P < 0.05). Conclusion Endocrine therapy combined with IMRT significantly improved the clinical efficacy of advanced prostate cancer, reduced PSA (prostate specific antigen) levels, and improved the metastasis-free survival rates.