Investigators have reported, at the American Society for Therapeutic Radiation and Oncology (ASTRO) 50th Annual Meeting, that when radiation is added to anti-androgen therapy (ADT), survival rates are increased by 50% in men receiving only ADT.
“This randomized trial is the first to show that men with locally advanced prostate cancer will survive substantially longer when radiation is added to their treatment plan,” said lead investigator Anders Widmark, MD, Department of Radiation Oncology, Umea University, Umea, Sweden.
The study looked at both survival and quality of life in 880 men with locally advanced prostate cancer. The men were randomized to 3 months of total androgen blockade followed by continuous ADT or the same hormonal therapy plus external beam radiation therapy.
The researchers found that when radiation therapy was added to hormone therapy the 10-year mortality rate was cut in half. Eighteen percent of the men who underwent hormone therapy alone died of prostate cancer versus 8.5% of those patients who had both hormone and radiation treatment.
Quality of life, was also assessed four years later. The men reported that those in the combined radiation arm were “slightly worse” compared with hormone therapy alone. Reported morbidity issues consisted of moderate to severe urinary leakage, pain on urinating, and erectile dysfunction. These issues were more common after combination treatment than after hormonal therapy alone.
Clearly, adding radiation to hormone therapy offers the potential for substantial survival benefits, but it also offers the possibility of additional morbidity problems. However, the increase in symptoms seems to be an acceptable when considering the significant possibility of life extension.
If you have advanced local disease you should talk with your doctor to see if you might be a candidate. If the disease has progressed out of the prostate bed area then the addition of radiation will not extend life.
Joel T Nowak MA, MSW