Prostate Cancer Survival Prolonged by Radiation Plus Hormone Therapy

Study finds many patients not receiving radiation treatment.

The addition of radiation treatment to hormone therapy can save the lives of more men with locally advanced prostate cancer than hormone therapy alone, according to a recent study.

A pair of significant clinical trials previously revealed that radiation plus hormone therapy generates a large survival improvement in younger men compared with hormone therapy alone, but there was no comparable research on the treatment for older men with advanced prostate cancer.

Researchers from Penn Medicine determined that treatment with hormone therapy plus radiation was able to reduce cancer deaths by approximately 50% in men aged between 76 to 85 years compared with men who only received hormone therapy. Prior studies indicated that 40% of men with aggressive prostate cancers receive just hormone therapy, which reveals a large gap in curative cancer care in patients approaching in their 70s.

“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,” said lead author Justin E. Bekelman, MD, in a press release. “Patients and their physicians should carefully discuss curative treatment options for prostate cancer and reduce the use of hormone therapy alone.”

As opposed to slow growing tumors, locally advanced prostate cancer is aggressive and prone to metastasize, which leads to death from the disease. Hormone therapy is able to lower or block the levels of androgens that feed prostate cancer tumors.

The current study evaluated treatment with radiation plus hormone therapy versus hormone therapy alone in 31,541 men with prostate cancer aged from 65 years to 85 years. In men aged 65 to 75 years, radiation plus hormone therapy was found to reduce prostate cancer deaths 57% compared with hormone therapy alone, from 9.8% to 4.4% of patients at 7 years follow up.

In men 76 to 85 years of age, radiation plus hormone therapy reduced prostate cancer deaths 49% compared with hormone therapy alone, from 9.8% to 5% of patients at 7 years follow-up. Radiation plus hormone therapy also led to approximately one-third less deaths from any cause in both treatment groups.

The study also showed that side effects from radiation plus hormone therapy are acceptable compared with hormone therapy alone.

“Older men with aggressive prostate cancers should know that the combination of radiation plus hormone therapy is both tolerable and effective in curing prostate cancer,” Dr. Bekelman said.