According to the results of a study recently published in the Journal of Clinical Oncology, the addition of radiation treatment to treatment with androgen-deprivation therapy (ADT) in older men with locally advanced prostate therapy prolongs survival when compared to treatment with androgen-deprivation therapy alone. The researchers reported that ADT plus radiation reduced cancer deaths by nearly 50% in men aged 76 to 85 compared to men who only received ADT.
Clinical trials have demonstrated that radiation plus androgen-deprivation therapy produces an improvement in survival in younger men relative to treatment with androgen-deprivation therapy alone and the combination is considered a standard treatment approach. Many older men however are not routinely offered radiation therapy and are treated with ADT alone.
In the current study 31,541 men with prostate cancer aged 65 to 85 years of age in the Surveillance, Epidemiology, and End Results (SEER)-Medicare database were identified and evaluated. Individuals treated with the combination of radiation plus ADT were compared to those treated with ADT alone. Among men aged 65 to 75 years old, radiation plus ADT was associated with a reduction in prostate cancer deaths of 57% relative to ADT alone. Among men aged 76 to 85 years old, radiation plus ADT was associated with a reduction in prostate cancer deaths of 49% relative to ADT alone.
The results of this study suggest that individuals with locally advanced prostate cancer over the age of 65 can benefit from combined treatment with ADT and radiation. Importantly, patients should discuss all treatment options with their physician irrespective of their age. Results from clinical trials attained in younger individuals are often generalizable to older populations and patients should not undergo age discrimination.
Reference: Bekelman J, Mitra N, Handorf E, et al. Effectiveness of Androgen-Deprivation Therapy and Radiotherapy for Older Men With Locally Advanced Prostate Cancer JCO JCO.2014.57.2743; published online on January 5, 2015.