Comparing therapies in the treatment of high-risk prostate cancer patients

This study compared the effects of different therapies in the treatment of high-risk prostate cancer. Failure of treatment and mortality rates were compared between the use of external beam radiotherapy (EBRT) and combined modality radiotherapy (CMRT). The effect of adding androgen deprivation therapy (ADT) to the treatment plan was also reviewed.

High-risk prostate cancer (HRPCa) patients are those with advanced tumors (cancers with a high Gleason score, at an advanced clinical stage, or patients with high PSA levels). These patients are often treated with radiotherapy. This radiation treatment damages cancer cells and prevents tumor growth. External beam radiotherapy (EBRT) involves projecting X-ray radiation at the tumor from an external device. Combined modality radiotherapy (CMRT) involves radiation therapy to the pelvic area, combined with a form of internal radiation therapy called brachytherapy. Brachytherapy involves implantation of radioactive (radiation emitting) particles directly into the cancer.

Since prostate cancer growth is fueled by male sex hormones such as testosterone, blocking the production or effect of these hormones is another proven treatment for prostate cancer. This line of treatment is referred to as androgen deprivation therapy (ADT).

This study involved 958 HRPCa patients who were followed for an average of 63.2 months. After 5 years, 27% of patients treated with EBRT and 11% of those treated with CMRT experienced treatment failure (lack of tests indicating improvement after treatment). After 8 years, 40% of patients treated with EBRT and 13% of those treated with CMRT experienced treatment failure. After 8 years the rate of mortality due to cancer was 14% in patients treated with EBRT, while CMRT treated patients registered a mortality rate of 7%.

Addition of ADT to radiotherapy significantly reduced the rate of treatment failure and mortality in both treatment groups.

In summary, the addition of brachytherapy to conventional radiotherapy (or CMRT) reduces the risk of treatment failure and death in high-risk prostate cancer patients. Addition of ADT to radiation therapy also showed a similar benefit.

This study failed to address the possible toxic side effects related to these treatments.

Consult with your physician regarding the best treatment strategy tailored to your condition.