Intensity-modulated radiation therapy offers long-term survival in PCa patients

Prostate cancer patients receiving high-dose, intensity-modulated radiation therapy (IMRT) remained disease-free after an 8-year follow-up in a study conducted by researchers at Memorial Sloan-Kettering Cancer Center, New York. Of the 561 patients, 89% of the men in the favorable-risk group were disease-free and none of the men in any group developed secondary cancers as a result of the radiation therapy (J Urol 2006; 176:1415-9).

“Our results suggest that IMRT should be the treatment of choice for delivering high-dose, external beam radiotherapy for patients with localized prostate cancer,” said lead author Michael J. Zelefsky, MD. “We were able to show long-term safety and long-term efficacy in a very diverse group of prostate cancer patients that were followed-many for as long as 10 years.

“Despite the fact some patients had an aggressive form of their disease with high Gleason scores and PSA levels, the overwhelming majority of patients had good tumor control with neither recurrence of their original cancer nor development of secondary cancers, which one might have expected from the high doses of radiation.”

The 8-year results showed that urinary continence was maintained for all patients. The therapy was curative for the majority of patients in all three prognostic risk groups, with 89% of the favorable, 78% of the intermediate, and 67% of the unfavorable groups alive after an average of 8 years. Of those men who were potent prior to IMRT, erectile dysfunction developed in 49%.

“There is still room for improvement,” Dr. Zelefsky said. “We are incorporating image-guided approaches that may continue the excellent tumor control but further limit the area we are irradiating and reduce side effects.”