Radiotherapy in node-positive prostate cancer patients

The authors determined the effect of radiotherapy as an additional treatment, in patients with node-positive prostate cancer. 

Radiotherapy is a common treatment used in prostate cancer. It involves directing a beam of radiation at the tumor site to kill cancer cells with minimal damage to surrounding healthy cells. In some cases, prostate cancer can spread outside of the prostate. Patients with node-positive cancer have cancer in their lymph nodes (sites that hold the immune cells). Adjuvant radiotherapy (treatment given after the primary treatment) can be given to patients with node-positive prostate cancer to improve survival.

Further studies are required to determine the effectiveness of adjuvant radiotherapy in node-positive prostate cancer. 

The authors aimed to determine the effect of adjuvant radiotherapy in patients with node-positive prostate cancer.

1,107 patients were included in this analysis with an average follow up time of 8.4 years. 35% of patients received adjuvant radiotherapy.

All patients underwent prostate surgery (surgical removal of the prostate glands). All patients were treated with hormone therapy (targets the male sex hormones active in prostate cancer, such as testosterone). Patients treated with adjuvant radiotherapy and hormone therapy had a cancer specific mortality-free  survival (patients who did not die from the cancer following treatment) rate of 92.4% at 8 years. Patients treated with hormone therapy alone had a survival rate of 86.2%. Patients treated with radiotherapy and hormone therapy had an overall mortality-free survival (patients who did not die following treatment) of 87.6%. This was compared to 75.1% in patients who received hormone therapy alone.

Overall, two groups of patients benefited from adjuvant radiotherapy. Group 1 included patients who had less than 2 positive lymph nodes, Gleason score (scoring system comparing cancer cells to healthy cells) of 7 to 10 and patients with more advanced prostate cancer (spread outside of prostate to other organs). Group 2 included patients with more than 3 or 4 positive lymph nodes. 

The authors concluded that patients with fewer positive lymph nodes but with more advanced prostate cancer and patients who had 3 or 4 positive lymph nodes were ideal candidates for adjuvant radiotherapy following surgery. 

If you are considering radiotherapy as an adjuvant treatment, please discuss potential risks and benefits with your doctor.