Hormonal treatment improves survival in high-risk prostate cancer patients

Administering hormonal treatment in addition to radiation therapy in patients with high-risk prostate cancer can improve survival rate, according to a new study published in the April 1, 2005, issue of the International Journal of Radiation Oncology-Biology-Physics, the official journal of ASTRO, the American Society for Therapeutic Radiology and Oncology.

The study, conducted between1987 and 1992, separated 977 patients into two groups: the adjuvant arm and the observation arm. Those in the adjuvant arm received radiation therapy and goserelin acetatc, a type of hormonal agent. The patients in the observation arm received radiation therapy only. Goserelin acetatc was administered only if they experienced a relapse.

As of July 2003, the median follow-up for all patients was 7.6 years and for surviving patients, 11 years. At ten years, the overall survival rate was significantly higher for the adjuvant arm than the observation arm – 49 percent to 39 percent, respectively. The local failure rate at ten years for the adjuvant arm was 23 percent and 38 percent for the observation arm and the ten year rates for cancer metastasizing to other parts of the body were 24 percent for the adjuvant patients versus 399 percent for the observation patients. Finally, the prostate cancer-related death rate was 16 percent for adjuvant and 22 percent for the observation arm.

"The results of the study firmly establish the role of adjuvant hormonal management in high-risk carcinoma of the prostate treated with definitive radiotherapy," said Miljenko V. Pilepich, M.D., a radiation oncologist at the University of California, Los Angeles and lead author of the study.