Improved Prostate Cancer Survival With Combo Therapy
Addition of short-term androgen deprivation therapy before and during radiotherapy is beneficial
WEDNESDAY, July 13 (HealthDay News) -- Short-term androgen deprivation therapy (ADT) combined with radiotherapy improves survival in patients with early, localized prostate cancer compared to radiotherapy alone, according to a study published in the July 14 issue of the New England Journal of Medicine.
Christopher U. Jones, M.D., from the Radiological Associates of Sacramento in California, and colleagues examined the effects of short-term ADT combined with radiotherapy versus radiotherapy alone in 1,979 individuals with early, localized prostate adenocarcinoma (stage T1b, T1c, T2a, or T2b) and a prostate-specific antigen level of 20 ng/mL or less between 1994 and 2001. Of these, 992 patients were treated with radiotherapy alone and 987 with a combination therapy of radiotherapy and four months of ADT beginning two months prior to the radiotherapy. Overall survival was the primary end point, and secondary end points were disease-specific mortality, distant metastases, biochemical failure, and rate of positive findings on repeat prostate biopsy at two years.
The investigators found that the 10-year overall survival rate was significantly higher for the combined therapy group compared with patients receiving radiotherapy alone (62 versus 57 percent; hazard ratio [HR] for death with radiotherapy alone, 1.17). A significant decrease in 10-year disease-specific mortality was observed in patients receiving the combination therapy compared to those receiving radiotherapy alone (from 8 to 4 percent; HR for radiotherapy alone, 1.87). Combination therapy also resulted in significant improvements in the other secondary end points. Toxic effects due to radiation were similar in both the groups. The incidence of toxic effects due to hormone therapy was less than 5 percent.
"The addition of short-term ADT provides a survival benefit for men with intermediate-risk prostate cancer who receive conventional doses of radiotherapy," the authors write.
Two authors reported financial ties to the pharmaceutical and medical device industries.