Long‐term outcomes in 1121 Australian prostate cancer patients treated with definitive radiotherapy

Introduction Optimal definitive treatment of prostate cancer is controversial, especially in high‐risk patients. We report the largest prospective cohort of Australian patients treated with radiotherapy for localised prostate cancer. Methods One thousand, one hundred and twenty‐one patients with prostate cancer were prospectively registered and treated to a dose of 70–74 Gy. Patients were classified as low, intermediate or high risk based on PSA, clinical staging and Gleason score. Intermediate‐risk patients were treated with 0–6 months of hormonal therapy (ADT) and high‐risk patients were offered neoadjuvant and adjuvant ADT. Overall survival (OS) and biochemical relapse‐free survival (bNED) were calculated using the Kaplan–Meier method. Results Median follow‐up was 92 months. Eight‐year OS and bNED were 78.4% and 68.1% respectively in the entire cohort. OS for the low, intermediate and high‐risk groups was 84.5%, 78.4% and 68% respectively. For these risk groups, bNED was 80.3%, 65.7% and 53.7% respectively. In the intermediate and high‐risk group, OS and bNED decreased with increasing number of risk factors. Conclusion Definitive radiotherapy is an effective treatment for prostate cancer, including in high‐risk cases.