Radiation Reduces Mortality Risk of Recurrent Prostate Cancer

Ten-year prostate cancer survival was substantially higher for men given salvage radiotherapy alone or with hormonal therapy than for those who received no salvage therapy (86%, 82%, and 62%, respectively, P0.0001), reported Bruce Trock, M.D., of Johns Hopkins University, and colleagues.

The advantage extended even to those who waited for up to two years after biochemical recurrence to start radiotherapy, Dr. Trock told attendees at the American Society of Clinical Oncology Genitourinary Cancers Symposium. Early salvage treatment was critical; salvage radiotherapy improved prostate cancer-specific survival only if given 2 years after biochemical recurrence.

Currently only about a quarter of men with biochemical recurrence receive radiation and about half are not treated, commented Howard M. Sandler, M.D., of the University of Michigan Health System in Ann Arbor, who moderated a press conference where

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the results were presented.  “By Showing that there’s a survival advantage to salvage radiotherapy, this study might increase the utilization of that particular androgen strategy after surgery,” he said.

When adjuvant radiation therapy is given, Dr. Trock said, it is often done immediately after their surgery for men with high-risk features because trials have shown that doing so can prolong survival.  If the findings of the retrospective study are validated, it may be safe to hold off on adjuvant radiation until recurrence, Dr. Trock said.  “It could eventually support a way to determine who should get immediate adjuvant radiation and who could wait until the time of recurrence to have salvage therapy,” he said.

However, he emphasized repeatedly, the findings were preliminary because of the retrospective nature of the study.  He said a clinical trial is needed to validate the results.

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