Shortened Radiation Course Demonstrates Similar Long-Term Adverse Events For Patients With Prostate Cancer Following Prostatectomy

Patients with prostate cancer who had their prostates removed did not experience increased adverse events (AEs) if they received fewer, higher doses of radiation, according to the results of the phase 3 NRG Oncology GU003 trial presented at the American Society for Radiation Oncology (ASTRO) Annual Meeting. The multi-institutional clinic trial also concluded that there was no negative impact to quality of life for these patients.

Prostate cancer is highly treatable, with 98% of patients living 10 years or more following treatment. This high survival rate makes quality of life and long-term AEs from treatment important considerations. The use of shorter radiation courses is already a practice standard for patients who choose not to have prostatectomy surgery, but this is the first trial to test whether an accelerated approach is viable for patients post-surgery.

"Delivering post-prostatectomy radiation therapy with fewer treatments is a win when it comes to reducing the burden of prostate cancer on society. For patients, fewer treatments equate to a shorter time commitment that increases access to a potentially curative treatment, reduces expenses related to travel and co-pays, and involves less time away from work and other responsibilities," said Mark K. Buyyounouski, MD, a professor of radiation oncology and director of genitourinary cancers in the Department of Radiation Oncology at Stanford University’s School of Medicine, in a press release. "Additionally, providers can improve their facility’s productivity and increase the overall capacity for all patients. And for payors, fewer treatments mean fewer expenses.”

The investigators compared patient-reported genitourinary (GU) and gastrointestinal (GI) AEs following hypofractionated, post-operative radiation therapy delivered over 5 weeks to those experienced by patients treated with conventionally fractionated radiation delivered over 7 weeks. The average change to patients’ GU scores immediately following treatment did not differ between treatment groups. Patients treated with shortened radiation initially reported worse GI symptoms, but 6 months following treatment, there were no significant differences in scores reported by either group.

“Short-term side effects of radiation therapy are well-established, and patients understand that,” Buyyounouski said. “What patients ultimately want to know is whether the side effects will go away, and that's what we saw in our study. There was some increase in bowel side effects, more so with the shorter treatment, but, after 6 months, these side effects resolved—and patients didn’t report any further or additional bowel or bladder side effects 1 and 2 years later."

REFERENCE

Shortened course of radiation therapy offers similar long-term side effects following prostate removal surgery [news release]. EurekAlert; October 25, 2021. Accessed October 26, 2021. https://www.eurekalert.org/news-releases/932538