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Adding radiotherapy to prostate cancer treatment improved survival in trial

By Allen Cone
A trial found men with advanced prostate cancer lived longer when they were treated with radiation therapy and standard treatment in a trial in Britain. Photo courtesy of National Cancer Institute
A trial found men with advanced prostate cancer lived longer when they were treated with radiation therapy and standard treatment in a trial in Britain. Photo courtesy of National Cancer Institute

Oct. 22 (UPI) -- Men with advanced prostate cancer lived 11 percent longer when treated with radiation therapy and standard treatment, including chemotherapy, in a trial in Britain.

More than 2,000 men participated in one of the largest clinical trials for the disease from 2013 to 2016 at hospitals in the Britain and Switzerland. Researchers at the University of Birmingham, which received funding from Cancer Research UK, published the findings in The Lancet and presented them at the European Society for Medical Oncology Annual Meeting in Munich, Germany.

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Prostate cancer, the most common malignancy among men in the United States, will affect approximately 11.6 percent of men during their lifetime, according the National Cancer Institute. The National Cancer Institute estimates there were nearly 27,000 deaths from the disease in 2017.

Researchers in the new study say radiotherapy, alongside hormone therapy, should become the standard of care for men with advanced prostate cancer.

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"Until now, it was thought that there was no point in treating the prostate itself if the cancer had already spread because it would be like shutting the stable door after the horse has bolted," leader researchers Dr. Chris Parker said in a press release. "However, this study proves the benefit of prostate radiotherapy for these men. Unlike many new drugs for cancer, radiotherapy is a simple, relatively cheap treatment that is readily available in most parts of the world."

Researchers selected 2,061 participants from the ongoing STAMPEDE trial, who had a median age of 68, giving them either standard treatment of androgen deprivation therapy with docetaxel chemotherapy while the other half received standard treatment and radiotherapy to the prostate. Patients were followed up every six weeks until six months, then every 12 weeks to two years, then every six months to 5 years and annually thereafter.

Prostate cancer led to the death of 391 in the standard therapy group and 314 in the group receiving radiation.

Roughly 40 percent of participants' cancer had spread to lymph nodes or nearby bones. Of these, about 80 percent survived for at least three years if they received radiotherapy. In comparison, 70 percent of men who did not have the additional radiotherapy treatment were alive after three years.

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They found no increase in survival among men whose cancer had spread to other organs or distant bones.

"Although survival times are improving, no one with advanced prostate cancer is cured of their disease by hormone therapy alone," said Dr. Nicholas James, chief investigator for the trial at the University of Birmingham. "These important results move the dial significantly further in terms of what we can do for this large group of men. These results should change the standard of care for certain men with advanced prostate cancer -- and could be implemented tomorrow."

In March, researchers at UCLA published a study with similar results.

The analysis covered treatment of 1,809 patients between 2000 and 2013, with the researchers finding that high doses of radiotherapy and hormonal therapy offered the best chance for decreasing death risk from aggressive prostate cancer. The patients lived in the United States and Europe.

They found the combination works best to prevent metastatic disease and improved overall long-term survival of men with cancers that are Gleason score of 9 or 10, which is considered high-grade and are often more aggressive cancers.

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