Hormone alone? Maybe not; hormone therapy plus radiation improves prostate cancer survival

The authors aimed to determine whether hormone therapy alone or hormone therapy combined with radiation improved survival in prostate cancer patients. 

Hormone therapy is a type of prostate cancer treatment that targets the male sex hormones active in prostate cancer, such as testosterone. Radiation therapy involves directing a beam of radiation at the tumor site in order to kill cancer cells with minimal damage to healthy cells. The dose of radiation given can differ depending on how advanced the cancer is, where higher doses are given in more advanced cancer patients. 

The aim of this study was to evaluate whether hormone therapy alone or hormone therapy in combination with radiation improved survival in prostate cancer patients.

1,205 patients were used in this study with an average follow-up time of 8 years. Patients were split into two groups – 602 patients in group 1 received hormone therapy alone and 603 patients in group 2 received hormone therapy and radiation. 260 patients (43%) treated with hormone therapy alone died and 205 patients (40%) treated with hormone and radiation therapy died.

Patients who received radiation therapy had a 30% reduced risk of death compared to patients who did not receive radiation. The average overall survival (patients who did not die from any cause following treatment) was 9.2 years in the hormone group, compared to 10.9 years in the hormone and radiation group. 10-year overall survival rates were 49% in the hormone group compared to 55% in the hormone and radiation group.

Disease-specific survival (patients who did not die from prostate cancer following treatment) rates were significantly reduced in patients who received both hormone and radiation therapy, who had a 54% reduced risk of experiencing prostate cancer death, compared to patients who received hormone therapy alone.

10-year disease progression-free rates (percentage of patients in whom disease did not worsen) were 46% in the hormone group compared to 74% in the hormone and radiation group. 10-year biochemical-free survival rates (percentage of patients who did not experience an increase in prostate specific antigen levels [PSA – protein elevated in the blood in the presence of prostate cancer]) were 27% in the hormone group compared to 63% in the hormone and radiation group.

The most common side-effects experienced were impotence (the consistent inability to sustain an erection for sexual intercourse, or adhieve ejaculation), hot flushes, urinary frequency, high blood pressure and decreased blood flow to the heart. Patients receiving both hormone and radiation therapy experienced bowel problems more frequently than those receiving hormone therapy alone.

The authors concluded that patients who received both hormone and radiation therapy had improved survival rates.

Further clinical trials are required for results to be widely applied in a randomized patient group.

If you are considering hormone or radiation therapy, please consult your doctor for potential risks and benefits.