November 02, 2011
Louis Potters, MD
The latest Lancet outlines the results of a large Phase III clinical trial that shows that men with locally advanced prostate cancer (that has not spread elsewhere) who receive radiation therapy on top of their androgen deprivation therapy (ADT) have greater overall survival compared to men on ADT alone.
Data suggests that the use of hormones without radiation therapy to manage men with high-risk prostate cancer has increased in the past several years. The results of the Warde study tell us that radiation therapy needs to be added as a component of care for these men.
Using newer technology such as intensity modulated radiation and image guidance, higher doses of radiation therapy can safely be delivered in high-risk patients. Yet using older technology and lower radiation doses than today’s standards, the authors demonstrated a remarkable 90 percent disease-specific survival for men with very high risk disease. Plus, these survival gains were achieved without any clear decrease in overall quality of life.
Based on high-level evidence, radiation therapy is saving lives of men with prostate cancer. Though other methods of treating high-risk prostate cancer exist, a radiation-based approach remains the standard against which other modalities needed to be measured. Randomized trials comparing different treatments are required to test if these other methods will be equally efficacious to radiation therapy.