A new study entitled “Effectiveness of Androgen-Deprivation Therapy and Radiotherapy for Older Men With Locally Advanced Prostate Cancer” reports the enhanced survival of patients with advanced prostate cancer when submitted to joint androgen-deprivation therapy with radiotherapy. The study was published in the Journal of Clinical Oncology.
Locally advanced prostate cancer is characterized by the spreading of cancer cells outside the prostate gland, but still within the surrounding area. However, patients diagnosed with this type of malignancy have an increase risk of developing cancer metastasis due to tumor aggressiveness.
In this study, the authors determined whether adding radiotherapy to androgen-deprivation treatment enhanced older patients’ survival, an hypothesis raised in two previously randomized clinical trials that focused on younger patients. The authors compared the survival rate of androgen-deprivation therapy with radiotherapy (ADT plus RT) when compared to ADT alone in three groups of patients – (1) a group of younger patients with ages similar to the previous clinical trials (from 65 to 75 years); (2) a group of elderly patients (older than 75 years) with locally advanced prostate cancer; (3) a third group composed of patients with screen-detected high-risk prostate cancer, older than 65 years.
Altogether, the team analyzed 31, 541 patients with prostate cancer. The authors found that within the group of men with ages between 65 to 75 years, combined therapy (ADT plus RT) yielded a 57 percent decrease in patient mortality, when compared to ADT therapy alone. The tendency was maintained in the elderly (75 and 85 years old) and screen-detected group with a 49 percent reduction in cancer-death.
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The results show that the previous clinical trial findings are maintained in an elderly prostate-cancer population and that using both radiation plus hormone therapy to treat these patients can significantly decrease cancer-associated death. Importantly, the results showed that the combination treatment is tolerable and safe.
Justin E. Bekelman, MD, an assistant professor of Radiation Oncology, Medical Ethics and Health Policy at Penn’s Perelman School of Medicine and Abramson Cancer Center and study leading author noted in a news release, “Failure to use effective treatments for older patients with cancer is a health care quality concern in the United States. Radiation plus hormone therapy is such a treatment for men with aggressive prostate cancers. Patients and their physicians should carefully discuss curative treatment options for prostate cancer and reduce the use of hormone therapy alone.”
