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Short-term
Hormone Therapy added to Radiation increases
survival for Medium-risk, but not Low-risk,
Prostate Cancer Patients
Newswise — Short-term hormone therapy given
prior to and during radiation treatment to
medium-risk prostate cancer patients
increases their chance of living longer,
compared to those who receive radiation
alone, however there is no significant
benefit for low-risk patients, according to
the largest randomized study of its kind
presented at the plenary session November 2,
2009, at the 51st Annual Meeting of the
American Society for Radiation Oncology (ASTRO).
This phase III study is one of the largest
clinical trials of prostate cancer therapy
ever completed, with 2,000 low- and
intermediate-risk patients enrolled in the
trial from October 1994 to April 2001.
Researchers from the Radiation Therapy
Oncology Group (RTOG) followed men with
early-stage prostate cancer for a period in
most cases of more than nine years. This
timeframe was sufficient to show improved
survival benefits of short-term hormone
therapy added to what was then the standard
radiation treatment for prostate cancer,
which involved slightly lower doses of
radiation than are currently used today with
newer techniques, such as intensity
modulated radiation therapy (IMRT).
“The study provides strong scientific
evidence that shows us when to deliver
hormone therapy with radiation in patients
with localized prostate cancer,” Christopher
U. Jones, M.D., an author of the study and a
radiation oncologist at Radiological
Associates of Sacramento in Sacramento,
Calif., said.
“Our findings show that men with low-risk
disease, which is the vast majority of
prostate cancer patients, have little to
gain from adding hormone therapy to
radiation.
"However,
men with intermediate-risk disease, which is
a significant minority of patients, gain a
benefit in overall survival from the
addition of only four months of hormone
therapy. Prior to this trial, it was unclear
whether or not combining hormone therapy
with radiation for medium-risk prostate
cancer patients improves survival.”
Androgen deprivation therapy is hormone
therapy used to treat prostate cancer by
stopping or lowering the level of male
hormones, or androgens, thereby removing the
strongest growth factor for prostate cancer
cells.
In the study, a total of 1,979 eligible men
who had cancer confined to the prostate and
a PSA less than or equal to 20 were
randomized to receive total androgen
deprivation therapy two months prior to and
two months during radiation treatment, or
radiation alone.
Findings show that short-term hormone
therapy given to early-stage prostate cancer
patients prior to and during radiation
treatment significantly increases their
chance of living longer (51 percent),
compared to those who receive radiation
alone (46 percent).
Nearly all of the survival benefit was in
the intermediate-risk group. Secondary
endpoints of disease-free survial, freedom
from biochemical failure, and positive two
year re-biopsy rates were also better in the
group who received short-term hormone
therapy and radiation treatment.
The study was supported by grants from the
National Cancer Institute.
For more information on radiation therapy
for prostate cancer, visit
www.rtanswers.org.
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