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Adjuvant Radiotherapy May Fight Advanced Prostate Cancer

Decade-long study finds significant decrease in tumor recurrence, but not deaths

TUESDAY, Nov. 14 (HealthDay News) -- A 10-year randomized, prospective clinical trial may provide guidance on the use of adjuvant radiotherapy after radical prostatectomy in men with pathologically advanced prostate cancer. The study, published in the Nov. 15 issue of the Journal of the American Medical Association, found the treatment could reduce prostate-specific antigen relapse and disease recurrence, but not overall patient survival.

As reported at a special American Medical Association men's health briefing in New York City on Nov. 14, Ian M. Thompson, Jr., M.D. and colleagues from the University of Texas Health Science Center at San Antonio, tracked outcomes for 425 men with pathologically advanced prostate cancer who had undergone radical prostatectomy. Patients were randomized to either 60 to 64 Gy external-beam radiation or usual care plus observation.

Over a median 10.6 years of follow-up, the researchers noted significant differences between cases and controls in terms of prostate-specific antigen relapse-free survival (10.3 years versus 3.1 years, respectively) and disease recurrence (13.8 years versus 9.9 years). However, no significant difference was found in terms of metastasis-free survival or overall survival between the two groups, with 71 deaths recorded in those receiving radiotherapy versus 83 deaths for those who did not get the treatment.

Adverse effects were significantly higher in those receiving radiotherapy (23.8 percent) compared to those who did not (11.9 percent), and included rectal and urethral complications and urinary incontinence.

"The results of this study may provide guidance for clinicians and patients considering options for adjuvant therapy for pathologically advanced disease," the authors write.

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