For Prostate Cancer Patients at High Risk of Recurrence Don't Benefit from Short-Term Androgen Deprivation, Fox Chase Cancer Center Study Finds; Escalating Radiation Dose Is Better
PHILADELPHIA (Oct. 9, 2002)-Two strategies exist to treat men with high-risk prostate cancer-patients with advanced-stage, high-grade tumors or high pretreatment levels of prostate-specific antigen (PSA) in the blood. One treatment strategy uses three-dimensional conformal radiation therapy to deliver high doses of radiation to the prostate. The other modality combines external beam radiation with androgen deprivation. Androgen stimulates prostate tumor growth, so depriving the body of this hormone by administering medications that can hinder the production of testosterone can help control the cancer.
Several studies have found that combining external radiation therapy and androgen deprivation for men with prostate cancer improves treatment results, including lowering PSA levels. Various other studies, including those by Gerald E. Hanks, M.D., former radiation oncology chairman at Fox Chase Cancer Center, and Fox Chase's current radiation oncology chairman, Alan Pollack, M.D., Ph.D., have shown the benefit of treating high-risk prostate cancer patients with higher radiation doses. However, escalating the radiation dose may come at the cost of increased rectal side effects.
A new study at Fox Chase compared the results of the two competing strategies. The goal was to determine whether the addition of short-term androgen deprivation can substitute for radiation dose escalation to limit radiation side effects without compromising long-term clinical and PSA results.
The study revealed that short-term androgen deprivation held no benefit for high-risk patients in terms of PSA levels, the spread of the cancer to other parts of the body (distant metastases) or overall survival. Fox Chase radiation oncologist Khanh H. Nguyen, M.D., presented the study results Wednesday, Oct. 9 at the 44th annual meeting of the American Society for Therapeutic Radiology and Oncology (ASTRO), held in New Orleans Oct. 6-10.
The study included 296 high-risk patients. Half received radiation therapy plus short-term androgen deprivation while the other group received higher doses of radiation alone.
"Our data demonstrate that short-term androgen deprivation is not a substitute for radiation dose in the treatment of high-risk prostate cancer," Nguyen said. "This suggests that radiation dose remains an important element in the treatment of these patients."
Other authors of the study include biostatistician Alexandra L. Hanlon, Ph.D., radiation oncologists Eric M. Horwitz, M.D., and Alan Pollack, M.D., Ph.D., and urologic surgical oncologist Robert G. Uzzo, M.D., all of Fox Chase Cancer Center.
Fox Chase Cancer Center, one of the nation's first comprehensive cancer centers designated by the National Cancer Institute in 1974, conducts basic and clinical research; programs of prevention, detection and treatment of cancer; and community outreach. For more information about Fox Chase activities, visit the Center's web site at www.fccc.edu.
Fox Chase Cancer Center, part of Temple University Health System, is one of the leading cancer research and treatment centers in the United States. Founded in 1904 in Philadelphia as one of the nation’s first cancer hospitals, Fox Chase also was among the first institutions to receive the National Cancer Institute’s prestigious comprehensive cancer center designation in 1974. Fox Chase researchers have won the highest awards in their fields, including two Nobel Prizes. Fox Chase physicians are routinely recognized in national rankings, and the Center’s nursing program has achieved Magnet status for excellence three consecutive times. Fox Chase conducts a broad array of nationally competitive basic, translational, and clinical research and oversees programs in cancer prevention, detection, survivorship, and community outreach. For more information, call 1-888-FOX-CHASE (1-888-369-2427).