Combination Therapy Can Cut Prostate Cancer Death Risk

Brachytherapy, androgen suppression and radiation more effective than brachytherapy alone

THURSDAY, July 16 (HealthDay News) -- The risk of death from prostate cancer is lower for patients treated with brachytherapy supplemented by external-beam radiation therapy (EBRT) and androgen suppression therapy (AST) than it is for those treated with brachytherapy alone, according to a study published online July 13 in the Journal of Clinical Oncology.

Anthony V. D'Amico, M.D., of Brigham and Women's Hospital in Boston, and colleagues evaluated the risk of prostate cancer mortality for high-risk patients treated with brachytherapy alone, in combination with EBRT alone or AST alone, or a combination of all three therapies. The researchers compared outcomes in 1,342 men with prostate-specific antigen levels of more than 20 ng/mL and disease rated as T3 or 4 or with a Gleason score of eight to 10. Multivariate regression analysis was used to estimate the risk of death in men in the treatment groups.

At median follow-up of 5.1 years, the researchers found that patients treated with brachytherapy and both EBRT and AST had a lower mortality risk (adjusted hazard ratio, 0.32) compared with those treated with brachytherapy alone. However, there was no risk improvement for patients treated with brachytherapy and only one of the supplemental treatments compared to brachytherapy alone.

"These data should heighten awareness among physicians that, to maximize curability in men with high-risk prostate cancer treated using brachytherapy, the addition of both supplemental AST and EBRT to brachytherapy seems necessary," the authors conclude.

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