In a nutshell
The authors aimed to determine whether long-term hormone treatment was superior to short-term treatment when used with radiation therapy.
Some background
Radiotherapy and hormone therapy are common treatments used in prostate cancer patients.
Radiotherapy 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 cases. Androgen deprivation therapy (ADT) is a form of hormone therapy that targets the male sex hormones active in prostate cancer, such as testosterone.
Methods & findings
The aim of this study was to determine whether short or long-term ADT treatment was more successful when combined with radiotherapy.
355 patients were used in this study with an average follow-up of 63-64 months. 178 received short-term ADT (4 months) and 177 received long-term ADT (24 months) following radiotherapy.
5-year biochemical disease-free survival (prostate specific antigen [PSA – protein elevated in the blood when prostate cancer is present] levels have not increased since treatment) was 81% in the short-term group compared to 90% in the long-term group. 5-year overall survival (patient did not die from prostate cancer following treatment) in the short-term group was 86% compared to 95% in the long-term group. 5-year metastasis-free survival (patient did not experience cancer spreading to other parts of the body following treatment) was 83% in the short-term group compared to 94% in the long-term group.
38 patients died in total. All 5 deaths occurred in the short-term group. 61 cardiovascular events (heart attack, heart problems etc) occurred during treatment, resulting in 8 deaths; 3 in the short-term and 5 in the long-term group. 8% of patients in the short-term group experienced moderate to severe rectal side-effects (diarrhea, inflammation, pain, bleeding) compared to 12% of long-term patients. 10% of patients from both short-term and long-term groups experienced moderate to severe urinary side-effects (bladder inflammation, infection, pain, incontinence).
The bottom line
The authors conclude that long-term ADT combined with radiotherapy improved patient survival.
The fine print
Longer follow-up and future experiments are required for results to be widely applied.
What’s next?
If you are considering hormone or radiation therapy please consult your doctor for potential benefits and risks.
Published By :
The Lancet. Oncology
Date :
Feb 18, 2015
