Radiation Therapy plus Hormone Therapy Cuts Prostate Cancer Deaths in Half

Radiation Therapy plus Hormone Therapy Cuts Prostate Cancer Deaths in Half
Researchers from Sweden have reported that combined radiation and hormonal therapy reduces deaths by 50% compared with hormonal therapy alone for treatment of locally advanced or high-risk prostate cancer. The details of this study appeared in an early online publication in Lancet on December 15, 2008.[1]

Patients with locally advanced high-risk prostate cancer are often treated with hormone therapy alone or with radiation plus hormonal therapy. Most recent studies have shown that patients with locally advanced prostate cancer have better outcomes when receiving combination therapy.

In 1996 researchers from the Scandinavian Prostate Cancer Group and the Swedish Association for Urological Oncology initiated a Phase III trial to evaluate the benefits of adding radiation to hormone therapy. The trial involved 875 patients who were randomized to receive either hormone therapy alone or combined hormone/radiation therapy. The median follow-up of this study was 7.6 years. The following table summarizes the main findings of this study:

Table 1: Hormone Therapy Alone Versus Combined Hormone/Radiation Therapy in Prostate Cancer

Hormonal Therapy

Radiation and Hormonal Therapy

Number of Patients

439

436

Ten-year Cancer Mortality

23.9%

11.9%

Ten-year Mortality

39.4%

29.6%

Ten-year PSA Recurrence

74.7%

25.9%

After five years urinary, rectal, and sexual problems were slightly more frequent in the combination group. These researchers concluded that the combination of radiation therapy and hormone therapy was superior to hormone therapy alone and cut the rate of prostate cancer deaths in half. Furthermore, the side-effect profile for the combination therapy was acceptable.

Comments: These data are consistent with the data reported in previous studies.

Reference:

[1] Widmark A, Klepp O, Solberg A, et al. Endocrine treatment, with or without radiotherapy, in locally advanced prostate cancer (SPCG-7/SFUO-3): An open randomized phase III trial. The Lancet [early online publication]. December 16, 2008.