In a new study, researchers found that adjuvant radiotherapy may help treat advanced prostate cancer.
The research was conducted by a team from the University of Helsinki.
Treatment recommendations for prostate cancer are largely based on cancer’s stage (TNM classification), cancer’s aggressiveness determined from a prostate biopsy (the Gleason score), and prostate-specific antigen (PSA) obtained from a blood test, as well as the risk categorisation determined on the basis of these.
The treatment options for a local, low-risk prostate cancer are established and the prognosis is good.
However, the prognosis for a higher-risk, locally spread or metastasized cancer is poorer, and there is no consensus on the treatments due to a lack of sufficient research data.
Cancer may be found to have extended to the surface of the removed prostate or to have already spread through the surrounding area of the prostate.
In the new study, the team examined whether radiotherapy after the removal of the prostate could benefit patients whose cancer had spread to the surface of the prostate or beyond.
At the moment, treatment practices in these situations vary.
The team examined 250 patients. Among these patients, 126 received adjuvant radiotherapy after the removal of the prostate, while the treatment of 124 patients consisted of the mere removal of the prostate.
Over the 9-year follow-up, the researchers found only two patients—one from each group—died of prostate cancer.
Based on PSA measurements, 82% of the members of the adjuvant treatment group were disease-free at the end of the follow-up period.
The number in the control group was 61%.
An increase in the PSA value usually precedes the recurrence of prostate cancer, and in the study, the patients with a maximum PSA of 0.4 mg/l were determined to be disease-free.
No metastases were detected in 98% of those in the adjuvant treatment group and 96% of those in the control group.
The team says tolerance for the adjuvant treatment was good, and it prolonged the disease-free period measured from the PSA compared to the mere surgical removal of the prostate.
Even so, the adjuvant treatment did not extend patients’ survival.
The team suggests that when making treatment decisions, it is important to discuss the available options openly with the patient.
One author of the study is professor Akseli Hemminki.
The study is published in the journal European Urology.
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