Adding radiation to hormone therapy is effective for locally advanced prostate cancer

This study examined the benefit of combining radiation therapy with androgen deprivation therapy (ADT) in older men and in men with aggressive cancer cells. Researchers reported reduced mortality risks with combination therapy in all groups studied. 

Radiation therapy is a common treatment for localized (confined) prostate cancer. In cases of locally advanced prostate cancer (tumor protruding into nearby tissue), the risk of disease progression is high. Therefore, aggressive treatment is needed early on. This often involves a combination of radiation and androgen deprivation therapy (ADT). ADT targets the production of androgens (male sex hormones such as testosterone) and reduces their effect on cancer cell growth.

Radiation therapy in combination with ADT has been found to be an effective treatment for locally advanced prostate cancer. However, more studies are needed to determine the effectiveness of this combination in older men and in men with particularly aggressive cancer cells.

The records of 31,451 men with locally advanced prostate cancer were analyzed to examine the benefit of combination therapy. 12,924 men were aged between 65 and 75 years (younger group). 14,340 men were aged 76 to 85 years (older group). 4,277 men were aged 65 to 85 years and had high-risk, aggressive cancer cells (high-risk group). The men in each group received either ADT alone or ADT in combination with radiation therapy. Treatment outcomes were followed for an average of 6 years.

After adjusting for other factors (such as ethnicity and other medical conditions), the risk of prostate cancer-specific mortality was significantly reduced with combination therapy compared to ADT alone. The risk was reduced by 57% in the younger group, by 49% in the elderly group, and by 75% in the high-risk group. The risk of mortality from all causes was also significantly reduced in each group with combination therapy.

Researchers concluded that ADT plus radiation therapy reduces the risk of mortality in men with locally advanced disease, regardless of age or high-risk cancer.