Radiation plus antiandrogen therapy improves prostate cancer survival, suggests research
Men with localised prostate cancer do better with radiotherapy combined with androgen deprivation treatment than with radiotherapy alone, suggest research findings presented at the European Society for Radiotherapy and Oncology 33rd annual congress in Vienna, Austria, today (7 April 2014).
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Michael Bolla, the study’s lead author, from Grenoble University Hospital, France, said that the findings would be expected to change clinical practice. “During multidisciplinary team meetings to discuss a patient’s treatment, this combined treatment approach should be one of the options proposed for men with localised prostate cancer that has an intermediate or high risk of growing and spreading,” he said.
The trial involved 819 men in 14 countries with intermediate- or high-risk localised prostate cancer. They were randomly assigned to receive three-dimensional conformal radiotherapy with or without androgen deprivation therapy. This comprised two injections, given three months apart, of a luteinising hormone–releasing hormone analogue, plus the oral antiandrogen bicalutamide for 15 days.
After a median follow-up of 7.2 years, radiotherapy plus hormone therapy was significantly better than radiotherapy alone for the endpoints of biochemical progression-free survival and clinical progression-free survival, with hazard ratios of 0.53 (0.42–0.67; P<0.001) and 0.63 (0.48–0.84; P=0.001), respectively.
In terms of toxicity, severe impairment of sexual function was significantly more frequent with combination therapy, at 27.0 per cent versus 19.4 per cent for radiotherapy alone.
“Although we need longer follow-up to assess the impact on these men’s overall survival, these findings need to be taken into account in daily clinical practice,” Professor Bolla remarked.
Citation: The Pharmaceutical Journal DOI: 10.1211/PJ.2014.11137062
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