Increased risk of disease progression in younger men: Analysis of factors predicting biochemical failure and castration-resistant prostate cancer after high-dose intensity-modulated radiation therapy for nonmetastatic prostate cancer

The aim of this study was to investigate the clinical significance effect age on disease control in men who received high-dose intensity-modulated radiation therapy (IMRT) for nonmetastatic prostate cancer (NMPCa). NMPCa patients with favorable intermediate very high-risk features (National Comprehensive Cancer Network risk classification) treated IMRT at our institution between September 2000 and May 2011 were analyzed retrospectively. Treatment consisted (74–78 Gy/37–39 fractions) combined 6 months neoadjuvant hormonal therapy. Multivariable analysis using Fine Gray's regression model performed evaluate whether initiation associated biochemical failure (BF) castration-resistant (CRPC) progression. A total 367 analyzed. median follow-up period 8.8 years after IMRT. 5- 10-year BF rates 22.1 31.7%, those CRPC 4.5 12.6%, respectively. revealed that a younger (cut-off: 70 old) significantly correlated both higher rate (hazard ratio: 1.691, P= 0.0064) 2.579, P = 0.0079). Younger had increased risks IMRT, may benefit from more intensive treatments. Our findings should be further tested prospective studies.