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Radiotherapy plus hormone therapy cut prostate cancer mortality by more than half

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ASTRO 50th Annual Meeting

BOSTON — The combination of radiation plus antiandrogen treatment caused disease-specific mortality in patients with prostate cancer to drop by more than 50%, according to the results of a trial conducted by the Scandinavian Prostate Cancer Group.

Anders Widmark, MD, a professor of radiation oncology at Umea University in Umea, Sweden, presented the results at the American Society for Therapeutic Radiology and Oncology’s 50th Annual Meeting.

“Radiation decreased prostate cancer-specific mortality from 18% with hormone therapy to 8.5% in the combination treatment,” Widmark said. “At 10 years, a 10% absolute survival benefit was seen by the addition of local radiotherapy at 70 Gy.”

Researchers in Sweden, Denmark and Norway randomly assigned men with locally advanced prostate cancer to three months of total androgen blockade, followed by continuous antiandrogen treatment (n=439), or to the same treatment plus radiotherapy (n=436).

The PSA recurrence rate in the hormone therapy arm was 70% after seven years vs. 17% in the combination arm. At 10 years, the rate was 75% for the hormone therapy arm and 26% for the combination arm.

Men in the combination arm did experience bowel symptoms more frequently, and 85% complained of erectile dysfunction compared with 72% in the hormone therapy group (P<.001). – by Jason Harris

The beauty of this study is that it affirms the role of radiation therapy in terms of local control and its impact in terms of survival and disease-specific survival. It was actually a brave study in that it will probably be one of the only randomized studies that cuts radiation therapy out of the role of treatment. In that sense, it’s an affirmation of the role of radiation to assist in local control, and there are plenty of data that show local control in prostate cancer has impacts on overall survival and distant metastatic-free survival.

– Louis Potters, MD

Chairman, Department of Radiation Medicine
North Shore-Long Island Jewish Health System

For more information:

• Widmark A. A randomized trial comparing antiandrogens with or without radiotherapy in the treatment of locally advanced prostate cancer: survival and QOL outcome. Presented at: the American Society for Therapeutic Radiology and Oncology’s 50th Annual Meeting; Sept. 21-25, 2008; Boston.