Evaluating the benefits of short term hormone therapy plus radiation therapy in patients with prostate cancer

This article looked at the benefit on survival of short term hormone therapy called androgen deprivation therapy (ADT), in combination with radiation therapy, for the treatment of patients with prostate cancer. 

Prostate specific antigen (PSA) is a protein produced by the prostate gland. Men with a healthy prostate have a small amount of PSA in their blood. Levels of PSA increase in the case of prostate disease and this is often the first sign leading to the diagnosis of prostate cancer. Treatment of prostate cancer lowers levels of PSA as cancer cells are destroyed.

Prostate cancers grow in response to androgens such as testosterone, which are male sex hormones produced mainly by the testicles. Removing the effects of androgens (either with medications which prevent its production or by surgical removal of the testicles) is called androgen deprivation therapy (ADT). ADT shrinks the cancer and stops it from growing. Radiotherapy used alongside ADT helps destroy the remaining cancer cells. Normally, in patients with high risk cancers, ADT medications are given over a long period of 2 to 3 years. This trial evaluated whether short term ADT of only 4 months could produce a similar beneficial effect in patients with localized prostate cancers (cancers that have not spread beyond the prostate to lymph nodes or other organs).

This trial compared four treatment strategies for localized prostate cancer, all of which included short term ADT. In total, 1070 patients took part in this study. 530 patients received radiation therapy only to the prostate, and 540 received radiation therapy to the entire pelvic region including the prostate gland. About half of the patients from each group received short term ADT after radiation therapy was completed, and the other half received short term ADT 2 months before, and throughout, radiation therapy. The ADT method used in this study was a a drug type called luteinizing hormone releasing hormone, which was injected under the skin.

In this study, a complete response to the treatment was defined as a PSA level of 0.3ng/ml or lower. After approximately 7 years of follow up, 744 of the 1070 participants (70%) achieved a complete response to treatment. Patients who did not achieve a complete response had a higher risk for the cancer to spread to distant organs or tissues (metastasize) and a reduced survival. No significant difference was seen between the four treatment groups in regard to achieving complete response to treatment.

Overall, this study showed that patients treated with short term ADT combined with radiation therapy achieved good control of the disease with lower risk of the cancer spreading and improved survival rates. 

This article did not present a complete analysis of the results comparing the different treatment groups. Only an overall assessment was provided. The side effects of ADT were not discussed. Also, in patients who do not achieve a complete response with short term ADT, long term treatment should be considered.

Consult with your physician regarding the best treatment combination and length of therapy for your condition.