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High-dose radiation therapy reduces the risk of relapse, but does not improve survival in men with prostate cancer

March 26, 2018 11:17

A recent study Oncology NRG NRG Oncology / RTOG 0126 showed that by high-radiation therapy did not improve survival for men with prostate cancer medium risk but improved biochemical control and indicators of distant metastases compared with standard radiation therapy. Men who have received radiation therapy with a higher dose, underwent smaller therapeutic effects to control tumors, which grew and spread to other areas of the body; however, they experienced more side effects than men to standard radiation therapy. This information will be invaluable to doctors and patients in choosing the best course of treatment. Research conducted by the Department of research Jeff Michalski, MD, Siteman Cancer Center at Washington University School of Medicine in St. Louis.

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The first study of its kind, which will test whether increasing the dose of radiotherapy can help to increase the life expectancy for these patients. In the study, 1499 participants were analyzed: 748 men were randomly assigned to an experimental radiation therapy, to get a higher dose of 79.2 Gy in 44 fractions, and 751 people were randomly assigned to standard radiation therapy drug for receiving 70.2 Gy in 39 Fractions . The median observation time of 8.4 years, there was no difference in overall survival. 8-year overall survival for patients treated with escalating doses of radiotherapy was 76%, and 8-year overall survival standard dose radiotherapy was 75%. Reported later sortable or more high-level toxicity of the gastrointestinal tract and urogenital system (more than 90 days from start of treatment) for patients in radiotherapy group with the higher dose (5-year cumulative incidence [GI / GU]: 21% / 79,2Gy 12% against 15% / 7% 70,2Gy).

"If we can safely conduct the irradiation with higher dose, my opinion - it should be done", - advised Michalski. "This indicates a lower risk of relapse, resulting in improved quality of life. But if we can not reach a" safe "dose of radiation therapy, we should not expose patients to the risk of serious side effects. If we can not protect them from damage to the rectum or the bladder, for example, we will probably have to give up on the dose of radiation therapy. It is important to develop a treatment plan for each patient in each case. "



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