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Low-risk patients can forgo long-term hormone therapy
Source: (cancerfacts.com)
Wednesday, October 06, 2004
ATLANTA – Oct. 6, 2004 – Men treated for prostate cancer with a low risk of recurrence or disease progression can safely skip long-term hormone therapy if they receive higher dose radiation therapy, a new study shows.
Led by Dr. Shelly Hayes of a Fox Chase Cancer Center, the researchers presented their study results at the 46th Annual Meeting of the American Society for Therapeutic Radiology and Oncology in Atlanta, Ga.
"The purpose of our study was to determine if certain patients with less aggressive disease might be treated inadequately with radiation alone and would benefit from the addition of hormone therapy," Hayes said in a news release. "It turns out that radiation dose is the critical factor and additional treatment is unnecessary."
Features of low-risk disease include a Gleason score of 7 or less, early stage with the tumor confined to the prostate and or a prostate specific antigen (PSA) level less than 30. Chemicals in the blood, called androgens, help nourish normal prostate tissue. In the case of prostate cancer, these hormones (e.g. testosterone) can stimulate the prostate cancer cells to grow faster.
Long-term androgen deprivation therapy has been shown to slow the progression of prostate cancer, but it can have side-effects that patients may not be able to tolerate. These include breast tenderness and enlargement, hot flashes, loss of libido, and impotence.
The researchers analyzed treatment and outcomes of 496 men treated with 3-dimensional conformal radiation therapy during the 10-year period between 1991 and 2001. The group with the best outcomes included patients whose Gleason scores ranged from 2 to 6 who received radiation doses equal to or greater than 72 grays (Gy) or patients with a Gleason score of 7 who received doses equal to or greater than 76 Gy.
In contrast, patients who fared poorly were those with a Gleason score of 7 who received less than 76 Gy and those with a PSA level greater than 10 who received less than 72 Gy of radiation.
The Fox Chase researchers concluded that patients with intermediate-risk prostate cancer do not need long-term androgen deprivation if they receive high-dose radiation--greater than 76 Gy.
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