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Study Shows Survival Benefit for Men with Intermediate-Grade Prostate Cancer


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Short-term hormone therapy given in combination with radiation therapy to men with early-stage prostate cancer increased their chances of living longer compared to treatment with radiation therapy alone, according to a clinical trial supported by the National Cancer Institute. Benefits of the combined treatment were limited mainly to people with intermediate-risk disease and were not seen for men with low-risk prostate cancer, researchers say. The results appeared in the New England Journal of Medicine. The trial was conducted by the Radiation Therapy Oncology Group.

The study enrolled nearly 2,000 men with low- and intermediate-risk prostate cancer and followed their health status for more than nine years. Study participants were randomly assigned to treatment with radiation alone or radiation plus short-term androgen deprivation therapy using drugs that drastically lowered their natural production of testosterone, a hormone that feeds prostate cancer growth.

Researchers reported a statistically significant improvement in overall survival after 10 years on the trial for participants who received the short-term ADT and radiation.

Researchers reported a statistically significant improvement in overall survival after 10 years on the trial for participants who received the short-term ADT and radiation compared with those who received radiation therapy alone. Radiation therapy plus short-term ADT was also associated with fewer prostate cancer-related deaths compared to radiation therapy alone.

Among men with low-risk disease, short-term ADT produced little improvement in 10-year overall or disease-specific survival. It is possible that, for people with low-risk disease, longer follow-up is required to reveal a benefit. However, given that shortterm ADT has substantial quality of life consequences, including hot flashes and higher rates of erectile dysfunction, and the 10-year disease-specific mortality in the radiation-alone arm for men with low-risk disease was one percent, the researchers note that these findings do not support adding short-term ADT for low-risk prostate cancer. Newer high-dose radiation treatments may also lessen the need for use of ADT in low-risk men.

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This article was published in Coping® with Cancer magazine, September/October 2011.