Localized prostate cancer in elderly patients - Outcome after radiation therapy compared to matched younger patients

Purpose: To detect a difference in outcome (disease-specific survival, loca l tumor progression, late toxicity, quality of life) after curative radioth erapy for localized prostate cancer in elderly as compared to younger patie nts. Patients and Methods: In a retrospective analysis 59 elderly patients (>74 years old) were matched 1 : 2 with younger patients from the data base acco rding to tumor stage, grading, pre-treatment PSA values and year of radioth erapy. Surviving patients were contacted to fill in a validated questionnai re for quality of life measurement (EORTC QLQ-C30). Median follow-up for el derly and younger patients was 5.2 and 4.5 years, respectively. Results: Overall survival at 5 years was 66% for the elderly and 80% for yo unger patients. Intercurrent deaths were observed more frequently in the el derly population. There was no age-specific difference in disease-specific survival (78% vs 82%), late toxicity or quality of life. Clinically meaning ful local tumor progression was observed in 15% and 14%, respectively, corr esponding to data from the literature following hormonal ablation. Conclusions: There is no obvious difference in outcome including disease-sp ecific survival, late toxicity and quality of life in elderly patients, com pared to a matched younger population. A clinically meaningful local tumor progression following radiotherapy or hormonal ablation only is rare. Local radiotherapy or, alternatively, hormonal ablation is recommended to preser ve local progression-free survival in elderly patients except for very earl y stage of disease (i. e. T1 G1-2 M0).