For some men with high-risk, locally advanced prostate cancer, treatment that combines radiation and hormone therapy may have better outcomes than hormone therapy alone.
In a study led by Canadian researchers from Queen’s University, men who underwent the combination therapy lived longer and were less likely to die from their prostate cancer than their counterparts, who had only hormone therapy.
The study was published in the December 17, 2011 issue of The Lancet.
Between March 1995 and August 2005, approximately 1,200 men with high-risk prostate cancer participated in the randomized study. Half received hormone therapy only. The other half received a combination of hormone therapy and radiation. The median follow-up time was six years.
Hormone therapy is also called androgen deprivation therapy. Prostate cancer cells feed on the hormone testosterone. Depriving the cancer cells of testosterone can keep them from growing and spreading.
After seven years, the researchers found:
- 74% of the men who had received the combination therapy were still alive.
- 66% of the men who had had hormone therapy only were still alive.
- Of the men who had had the combination therapy, 10% had died of their prostate cancer.
- Of the men who had had hormone therapy only, 26% had died of their prostate cancer.
Adding radiation therapy to hormone therapy also reduced the degree and rate at which prostate cancer progressed.
Few serious side effects of the radiation therapy were reported. Milder side effects included gastrointestinal and genitourinary issues, but these were not typical. Some men had “modest” bowel function problems. Overall, the authors said that side effects of radiation “are not a reason to withhold treatment.”
The study did have some limitations, which the authors acknowledged. For example, the researchers did not record data concerning hormone therapy and bone health, as the importance of this relationship, at the time, was “not appreciated.”
Overall, the authors noted that physicians should discuss combined radiation and hormone treatment with their patients who have locally advanced prostate cancer.
“Currently available treatment options can be combined to improve the chances for men with high-risk prostate cancer,” said senior author Wendy Parulekar in a press statement. Dr. Parulekar is an associate professor of oncology at Queen’s University.
Warde, Padraig, MB, et al.
“Combined androgen deprivation therapy and radiation therapy for locally advanced prostate cancer: a randomized, phase 3 trial”
(Published online: November 3, 2011)
Prostate Cancer Foundation
“Study may lead to revised treatment for prostate cancer”
(Press Release – November 3, 2011)