Radiotherapy in combination with anti-androgen hormone therapy halves the risk of death from prostate cancer 15 years after diagnosis compared with hormone therapy alone, according to results from a follow-up, longitudinal, Nordic study published in European Urology.1
“Before the turn of the century, it was tradition to castrate men with high-risk or aggressive local prostate cancer with no signs of spreading, as the disease at that point was thought to be incurable,” said Anders Widmark, senior physician and professor in the Department of Radiation Sciences, Oncology, Umeå University, Umeå, Sweden, and lead author of the study.
“When we published the first results of this study in the Lancet in 2009, we contributed to changing the attitude toward radiotherapy for older patients with advanced prostate cancer. In this follow-up study, we present even more evident results that clearly show how patients who previously were considered incurable, to a large extent can be cured and that these patients should therefore be offered radiotherapy as an additional treatment.”
Researchers recruited 875 patients treated for locally advanced prostate or aggressive prostate cancer at 40 clinics in Sweden or Norway between 1996 and 2002. The researchers continued to follow the patients as part of the Scandinavian Prostate Cancer Group and the Swedish Association for Urological Oncology. Initial results, published in 2009 in the Lancet, contributed to changing attitudes about treatment of older patients with prostate cancer.
This study compared treatment with an anti-androgen hormone pill commonly used to treat prostate cancer in Nordic regions and the anti-androgen therapy with local radiotherapy. Treatment with anti-androgen therapy alone resulted in a 34% risk of death at 15 years whereas the addition of radiotherapy reduced the risk to 17%.
In Sweden, prostate cancer is the most common cancer with an estimated 9000 diagnoses per year. The conventional treatment in Sweden is anti-androgen hormone therapy, which slows the growth of cancerous cells by blocking the growth stimulation of testosterone.
1. Fosså SD, Wiklund F, Klepp O, et al. Ten- and 15-yr prostate cancer-specific mortality in patients with nonmetastatic locally advanced or aggressive intermediate prostate cancer, randomized to lifelong endocrine treatment alone or combined with radiotherapy: final results of The Scandinavian Prostate Cancer Group-7 [published online ahead of print March 26, 2016]. Eur Urol. doi:10.1016/j.eururo.2016.03.021.