Comparing outcomes of radiation therapy and observation in patients over 80

This study examined different treatment options for elderly men with localized prostate cancer. Researchers reported that radiation therapy with or without hormone therapy was associated with a significant survival benefit when compared to observation alone.

Localized prostate cancer refers to cancer that is confined to the prostate gland. Radiation therapy is a common treatment of localized prostate cancer. It involves directing high-energy rays at the tumor site to kill cancer cells. Hormone therapy can be added to radiation therapy for a more intensive intervention. Hormone therapy targets male sex hormones, such as testosterone, active in cancer growth.

Since active treatment is often associated with a number of side effects, some men may benefit from observation. This involves no active treatment, but instead involves monitoring the cancer for any signs of progression or growth. For older men, the relative benefits of active treatment when compared to observation are still being investigated.

The aim of this study was to determine whether radiation with or without hormone therapy improves survival in elderly men compared to observation alone.

The records of 23,790 patients with localized prostate cancer aged 80 years or more were analyzed. 72.5% of men received observation alone. 27.5% underwent radiation therapy with or without additional hormone therapy. Patients were followed for an average of 50 months.

13,315 deaths occurred during the study period. 13.5% of these were due to prostate cancer. 11% of men in the observation group died from prostate cancer. This was significantly greater compared to men treated with radiation (8.4%). Overall, radiation therapy reduced the risk of mortality from prostate cancer at 10 years by 2.6%.

The risk of prostate cancer mortality differed depending on disease stage. Patients with low-grade disease (less aggressive cancer cells) treated with radiation therapy had a 3% reduced prostate cancer mortality risk. This was 2.2% for patients with intermediate-grade disease and 8.4% for patients with high-grade disease.

The survival benefit of active treatment was observed across different ethnicities, patients with good general health as well as patients with additional medical conditions.

The authors concluded that radiation therapy was associated with a significant survival benefit when compared to observation in elderly patients with localized prostate cancer.