Prostate Ca patients show improved survival when short-course hormone therapy is added to RT

The addition of a short course of androgen suppression therapy following radiation therapy improves survival in men with localized prostate cancer compared with radiation therapy alone, according to researchers from Brigham and Women's Hospital and the Dana Farber Cancer Institute, Boston. They found that a shorter, 6-month course of androgen blockade offers survival benefits similar to a longer course (>3 years).

"This study challenges the concept of whether or not 2 or 3 years of [hormonal] treatment are really needed," said lead investigator Anthony D'Amico, MD, PhD, whose findings were published in JAMA (2004; 292:821-7).

The study included 206 patients with clinically localized prostate cancer who were randomized to radiation alone or radiation plus 6 months of androgen suppression. At a mean follow-up of 4.5 years, patients treated with the combination therapy had a two-fold reduction in risk of death compared with those treated with radiation therapy alone.

He added that the greatest benefit appears to occur in men with Gleason scores of 7 or higher plus PSAs between 10.0 ng/mL and 20.0 ng/mL. Look for a more in-depth article on this research in the Oct. 1 issue of Urology Times.

In related news, the combination of androgen suppression, brachytherapy, and external beam radiation therapy increases cure rates in high-risk prostate cancer patients, according to a report in the International Journal of Radiation Oncology-Biology-Physics (2004; 59:1352-9).

The study followed 132 men with high Gleason scores, elevated PSA scores, or an advanced clinical stage of prostate cancer. The combination of the three therapies produced an 86% rate of freedom from recurrence after 5 years. Post-treatment prostate biopsies from 47 men were negative in 96% at the first biopsy and 100% at the last biopsy.

"This new approach of combining brachytherapy, external beam irradiation, and hormonal therapy to cure prostate cancer can be very effective for men with aggressive forms of the disease," said lead author Richard G. Stock, MD, of Mount Sinai School of Medicine, New York.