Long-term Androgen Deprivation Therapy Combined with High-dose Radiation Therapy for Prostate Cancer Improves Survival

Long-term Androgen Deprivation Therapy Combined with High-dose Radiation Therapy for Prostate Cancer Improves Survival

japanese PAH studyA new study entitled “Randomized Phase III Trial of Adjuvant Androgen Deprivation in Combination with High-dose Conformal Radiotherapy in Intermediate and High-Risk Localized Prostate Cancer,” presented at this years’ American Society for Radiation Oncology’s (ASTRO’s) 56th Annual Meeting shows the positive outcomes in the survival rates of treating prostate cancer patients with a combination of high-dose radiation therapy (HDRT) with androgen hormone suppression therapy (ADT). The meeting is being held at the Moscone Center in San Francisco, September 14-17, 2014.

The study followed 362 patients with prostate cancer from 9 cancer centers in Spain. Prostate cancer cells use androgen hormones (like testosterone) to grow. Thus, a current treatment for locally advanced prostate cancer relies on a co-treatment of radiation therapy (RT) with ADT.

In this study, the team of scientists evaluated if a treatment of HDRT combined with 28 months of androgen deprivation (a long-term androgen deprivation, LTAD) resulted in better patient outcomes when compared to HDRT combined with four months of androgen deprivation (short-term androgen deprivation, STAD).

To assess the efficacy of the treatment, the study’s primary endpoints were disease-free survival (bDFS) and toxicity scores (radiation-related side effects). Additionally, the authors measured metastasis-free survival (MFS) and overall survival (OS).

A total of 11 patients in the LTAD group and 15 patients in the STAD group had bDFS, and after a median follow-up of 63 months, the five-year bDFS was significantly higher in the LTAD group (89.8%) compared to the STAD group (81.3%).

Furthermore, metastasis free survival (MFS) and overall survival (OS) was significantly higher in the LTAD group (93.6% and 94.8%) when compared to the STAD group (83.4% and 86.1%).

Almudena Zapatero, MD, PhD, a radiation oncologist at Hospital Universitario de la Princesa in Madrid Spain and leading author of the study noted in an ASTRO press release, “The management of patients with intermediate- and high-risk prostate cancer is highly challenging. The clinician must choose the type of local treatment as well as the optimal timing and sequence of hormone therapy. Moreover, rapid and ongoing advances in treatment options require that physicians consider options that can impact both survival and quality-of-life. The five-year results of our study show that the combination of high-dose external radiotherapy utilizing new technologies, such as IMRT, VAMT and IGRT, and 28 months of hormone therapy are a very successful combination to achieve positive prostate cancer control. Of paramount consideration, LTAD therapy in combination with HDRT provides good quality of life through a non-invasive, safe and efficient treatment approach for patients with high-risk prostate cancer.”