© 2000 by Oxford University Press
Journal of the National Cancer Institute, Vol. 92, No. 23, 1874,
December 6, 2000
© 2000 Oxford University Press
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New Study Results Highlight Role of Radiation Therapy in Prostate Cancer
Several studies presented at the American Society of Therapeutic Radiation and Oncology annual meeting in October helped to clarify the role of radiation therapy in prostate cancer.
Boosting the radiation dose when treating men with early stage disease is associated with higher survival rates, but some physicians feared this efficacy might come at the cost of increasing serious complications in the surrounding normal tissue. A new study shows that complications can usually be avoided with the use of 3-D conformal radiation therapy.
Only one of 111 patients treated with 3-D CRT to 68.4 Gy of radiation suffered grade 3 complications (requiring hospitalization, surgery, or medical intervention for at least 6 months), compared with 18 expected when using standard external-beam radiation therapy, said lead investigator Jeff Michalski, M.D., of Washington University in St. Louis.
Of 274 men treated with 3-D CRT to a higher dose of 73.8 Gy, only three suffered grade 3 complications, compared with an expected 42. The study, conducted by the Radiation Therapy Oncology Group, also confirmed that 3-D CRT can be done well not only in academic medical centers but in community hospitals.
Another RTOG study found that long-term hormone treatment plus radiation can prevent recurrence and improve survival for men with locally advanced prostate cancer. After 1,520 patients were treated with androgen suppression 2 months before and 2 months during radiation therapy, half of them got an additional 2 years of hormone treatment. Of men receiving long-term hormone therapy, 4.3% died of prostate cancer compared with 7.2% of those in the control group.
Radiation therapy has frequently been viewed as a better option for older patients than younger ones with a longer life expectancy, because doctors believed late relapses are common. But a study presented at ASTRO showed that 91% of patients who had PSA levels less than 0.5 ng/mL 5 years after treatment remained disease-free 10 years after treatment. These results show that late relapses after RT are substantially less common than is believed, said Torunn Yock, M.D., who performed the study at Massachusetts General Hospital in Boston.
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