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Hormone therapy plus radiation improved OS in intermediate-risk, early-stage prostate cancers
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2010 Genitourinary Cancers Symposium
Men with intermediate-risk, early-stage prostate cancer had an increased survival benefit after receiving four months of total androgen suppression before and during radiotherapy compared with men who received radiation alone.
Phase-3 results from the RTOG 94-08 trial showed that endocrine therapy and radiation significantly improved OS in patients with T1b-T2b carcinoma of the prostate with PSA ≥20, said Christopher U. Jones, MD, a radiation oncologist with Radiological Associates of Sacramento. He discussed the results during a press conference held in advance of this week’s 2010 Genitourinary Cancers Symposium.
“The survival benefit for hormones was greatest among men judged to be at intermediate risk of failure,” Jones said. “The beneficial effects of hormones were seen in both the white and [black] populations.”
Researchers enrolled 1,979 eligible patients, including 400 black men, from October 1994 to April 2001. Patients were randomly assigned to total androgen suppression alone for two months, followed by radiotherapy (n=987) or radiotherapy alone (n=992).
Median follow-up was 8.4 months in the hormone therapy group and 8.1 months in the radiotherapy alone group. Estimated OS at 12 years was 51% in the hormone therapy arm and 46% in the radiation arm (P=.03).
Two years after treatment, 843 men underwent repeat prostate biopsies. There was no cancer evident in 78% of those treated with hormone therapy and radiation compared with only 60% in the radiation-only group.
Jones said the survival benefit associated with hormone therapy was greatest among the 54% of men in the study with intermediate-risk disease. Men with low-risk disease (35%) did not benefit from the addition of hormone therapy.
“The study does not support the routine addition of short-term androgen deprivation for these men,” he said of low-risk patients. “For the high-risk group, other studies have previously demonstrated that we need to treat these men with more than four months of androgen deprivation.” – by Jason Harris
For more information:
- McGowan DG. #6. Presented at: the 2010 Genitourinary Cancers Symposium; March 5-7, 2010; San Francisco.
This is a very important paper. It’s the first evidence that we have for the benefit of radiation in these intermediate-risk patients. This a major advance for these patients who are on the border between good risk and poor risk.
– Nicholas J. Vogelzang, MD
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