According to results presented at the 39th annual meeting of the American Society of Clinical Oncology, hormone therapy delivered directly following radiation therapy improves survival compared to later delivery of hormone therapy.
The prostate is a walnut-sized male sex gland that is located between the bladder and rectum. The prostate is responsible for secreting a substance that forms a component of semen. Treatment options are varied for patients with prostate cancer, often depending upon the stage, or extent, of the disease. Standard therapeutic options include radiation therapy, surgery to remove the prostate (prostatectomy), watchful waiting, chemotherapy and/or hormone therapy, often referred to as androgen suppression therapy. Androgen suppression therapy involves the reduction of male hormone levels, particularly testosterone, in the body, as male hormones have growth stimulatory effects on prostate cancer cells. Androgen suppression therapy can be achieved through the surgical removal of the testicles or through drugs that suppress levels of male hormones in the body. Researchers are continuing to evaluate scheduling of androgen suppression threapy in treatment regimens order to provide optimal results for patients with prostate cancer.
A multi-institutional study was recently conducted to compare the timing of androgen suppression therapy using the agent goserelin following radiation therapy in nearly 1000 patients with prostate cancer. This trial involved patients with prostate cancer that had spread to nearby tissues directly outside the prostate or nearby lymph nodes (T3). Patients were randomly selected to receive either initial radiation therapy followed immediately (adjuvant) by goserelin until time of cancer progression, or to receive initial radiation therapy followed by goserelin when the cancer recurred.
Survival at five years following initial treatment was 76% for patients treated with adjuvant goserelin, compared to 71% for patients treated with goserelin at the time of recurrence. Survival at 10 years following intial treatment was 53% for patients treated with adjuvant goserelin, compared to only 38% for patients treated at the time of recurrence.
The researchers concluded that this direct comparative trial demonstrates improved survival in prostate cancer with the use of adjuvant androgen suppression therapy, compared to initiating treatmetn at the time of recurrence. Results from previous clinical trials have demonstrated that androgen suppressive therapy administered prior to or during radiation therapy may further improve survival in patients with prostate cancer.
2 Patients with prostate cancer that has spread outside the prostate to nearby tissues or lymph nodes and are to undergo radiation therapy should speak with their physician about the timing of androgen suppression therapy.
- Pilepich M, Winter K, Lawton C, et al. Phase III trial of androgen suppression adjuvant to definitive radiotherapy. Long term results of RTOG study 85-31. Proceedings from the 39th annual meeting of the American Society of Clinical Oncology. May 2003. Abstract #1530.
- Roach M et al.
Journal of Clinical Oncology. 2003;21: 1904-1911.
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