Hormone and Radiotherapy Seen to Cut in Half Risk of Early Death in Aggressive Local Prostate Cancer

Hormone and Radiotherapy Seen to Cut in Half Risk of Early Death in Aggressive Local Prostate Cancer

Men with aggressive but local prostate cancer reduced by half their long-term risk of death from the disease when treated with hormone (antiandrogen) therapy that is combined with local radiotherapy, according to a new longitudinal Nordic study.

The study, “Ten- and 15-yr Prostate Cancer-specific Mortality in Patients with Nonmetastatic Locally Advanced or Aggressive Intermediate Prostate Cancer, Randomized to Lifelong Endocrine Treatment Alone or Combined with Radiotherapy: Final Results of The Scandinavian Prostate Cancer Group-7,” was published in the journal European Urology.

“Before the turn of the century, it was tradition to castrate men with high-risk or aggressive local prostate cancer with no signs of spreading, as the disease at that point was thought to be incurable,” Anders Widmark, a senior physician and professor at Umeå University in Sweden, who led the study, said in a recent news release.

“When we published the first results of this study in the Lancet in 2009, we contributed to changing the attitude towards radiotherapy for older patients with advanced prostate cancer. In this follow-up study, we present even more evident results that clearly show how patients who previously were considered incurable, to a large extent can be cured and that these patients should therefore be offered radiotherapy as an additional treatment.”

Multiple studies have proven that pelvic radiotherapy (RAD) combined with androgen deprivation therapy (ADT) prolongs survival, compared with radiotherapy alone, in patients with locally advanced prostate cancer (PCa). Nevertheless, endocrine therapy (ET) alone (medical or surgical castration or oral antiandrogens) may still be viewed as a therapeutic option in patients with locally advanced PCa.

No study with observation times beyond 10 years, however, has demonstrated improved survival after the addition of prostatic radiotherapy (RAD) to endocrine treatment alone.

Umeå University researchers and colleagues in Norway and Denmark compared a common Nordic pill-based hormone therapy (antiandrogen) and the same treatment method with the addition of local radiotherapy in a cohort of 875 patients with locally advanced prostate or aggressive prostate cancer. Follow-up analysis conducted 15 years after diagnosis revealed that hormone treatments with the addition of radiotherapy halved, from 34 percent to 17 percent, the risk of these patients dying from the cancer.

“We are also in the process of evaluating how hormone therapy against prostate cancer affects the patients’ quality of life. We will publish that study shortly,” Dr. Widmark concluded.