Radiation added to hormone therapy beneficial in locally advanced prostate cancer

NEW YORK (Reuters Health) - For men with locally advanced prostate cancer, the addition of radiation treatment to anti-androgen hormone therapy reduces the risk of prostate cancer-specific mortality by 50% over 10 years, compared to hormone treatment alone.

That's according to a randomized study presented during a plenary session Monday at the American Society for Therapeutic Radiology and Oncology's 50th Annual Meeting in Boston.

"This randomized trial is the first to show that men with locally advanced prostate cancer will survive substantially longer when radiation is added to their treatment plan," said lead investigator and study presenter Dr. Anders Widmark, of Umea University, Sweden.

The study team compared survival and quality of life of 880 men (median age, 67 years) with locally advanced prostate cancer (T3; 78%) who received three months of total androgen blockade followed by continuous anti-androgen therapy with that of men who received external beam radiation therapy plus the same hormonal therapy.

"Our findings were surprising," Dr. Widmark said; "radiation therapy added to hormone therapy cut the (10-year) mortality rate in half. Eighteen percent of patients who underwent hormone therapy alone died of prostate cancer versus 8.5% of those patients who had both hormone and radiation treatment."

Quality of life, measured both from the physician's perspective and the patient's perspective 4 years after treatment, was only "slightly worse" in the combination treatment arm, Dr. Widmark reported. Moderate to severe urinary leakage, pain while urinating and erectile dysfunction were more common after combination treatment than after hormonal therapy alone.

"Considering the substantial survival benefit, the increase in symptoms seems to be acceptable and of small influence on quality of life four years after treatment," the researchers conclude in a meeting abstract.

"I think external beam radiation treatment should be used along with hormone treatment to increase survival in men with locally advanced prostate cancer," Dr. Widmark told the conference.

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