Hormonal Blockade For Additional Two Years Following Radiation Treatment Increases Survival for High Risk Prostate Cancer Patients
Should be "standard of care" for locally advanced disease or high Gleason, RTOG randomized trial shows

Boston, MA /PSA Rising, NYC/, October 23, 2000 -- Long-term hormone treatment can prevent recurrence and improve survival for men who opt for radiation in locally advanced prostate cancer, a new study shows. The study by the Radiation Therapy Oncology Group was the largest phase III prostate radiation treatment clinical trial to date.

The study reviewed 1,520 patients; all patients were treated with hormones two months before and then two months during radiation therapy. Half of the patients received an additional two years of hormones (Goserelin, also called Zoladex) following radiation therapy.

"We saw a decrease in prostate cancer deaths among those patient who received the additional two years of Goserelin," says Gerald Hanks, M.D., of Fox Chase Cancer Center, Philadelphia, PA, chair of the multi-center study. Only 4.3 percent of patients treated with long-term hormones died of prostate cancer compared to 7.2 percent for those who were treated with short-term hormones, says Dr. Hanks, who presented the study at the American Society for Therapeutic Radiology and Oncology annual meeting in Boston, MA on October 23, 2000.

In addition, 78 percent of patients treated with short-term hormones compared to 53 percent of patients treated with long-term hormones had a rising PSA level five years after treatment, indicating their cancer had returned. Sixteen percent of patients treated with short-term hormones compared to 10 percent of patients treated with long-term hormones had metastatic disease at five years.

A subset of patients - those at the highest risk of cancer recurrence (tumors rated "Gleason score" 8-10) - also fared much better when treated with long term hormones. In these high-risk patients, an overall survival advantage was shown for the long-term patients (80 percent vs. 70 percent at five years) and only 12 patients died from prostate cancer compared with 29 in the short-term group. "This is the first study to carefully review this group of patients," notes Dr. Hanks.

"Our results set a new standard of treatment for patients with locally advanced disease," says Dr. Hanks.

Dr. Robinson presented the data on October 23 at the American Society for Therapeutic Radiology and Oncology annual meeting in Boston, MA.
edited by J. Strax at PSA Rising.

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