Using fewer—but higher—doses of radiation to treat men with prostate cancer who had their prostates removed does not increase long-term side effects or lower their quality of life compared to conventional radiation treatment, a new, multi-institutional clinical trial shows. Findings from the phase III NRG Oncology GU003 trial will be presented today at the American Society for Radiation Oncology (ASTRO) Annual Meeting.
"Delivering post-prostatectomy radiation therapy with fewer treatments is a win when it comes to reducing the burden of prostate cancer on society. For patients, fewer treatments equate to a shorter time commitment that increases access to a potentially curative treatment, reduces expenses related to travel and co-pays, and involves less time away from work and other responsibilities," said lead author Mark K. Buyyounouski, MD, a professor of radiation oncology and director of genitourinary cancers in the Department of Radiation Oncology at Stanford University’s School of Medicine in Stanford, California. "Additionally, providers can improve their facility’s productivity and increase the overall capacity for all patients. And for payors, fewer treatments mean fewer expenses.”
Prostate cancer is the second most common cancer in men. About 1 in 8 men in the U.S. will be diagnosed with the disease during their lifetime. Prostate cancer is highly treatable; 98% of patients live 10 years or more after treatment. Given the high survival rate, quality of life and long-term side effects from treatment are important considerations. "Preserving quality of life was a major priority when testing the shorter treatment course. It is important for patients to know that accepting a more convenient treatment doesn’t mean they have to compromise on quality of life," said Dr. Buyyounouski.
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The use of shorter radiation therapy courses is already a well-accepted practice standard for men who choose not to have prostatectomy surgery, based on the results of multiple randomized trials. This trial is the first to test whether an accelerated approach is also a viable option for men after undergoing prostatectomy. For men who choose to have initial surgery, radiation is indicated afterwards if rising prostate specific-antigen (PSA) levels indicate the cancer has returned.
Dr. Buyyounouski and his team compared patient-reported genitourinary (GU) and gastrointestinal (GI) side effects following hypofractionated, post-operative radiation therapy delivered over five weeks to those experienced by men treated with conventionally fractionated radiation delivered over seven weeks. Side effects were measured using the Expanded Prostate Cancer Index Composite (EPIC); patients reported how GU and GI symptoms affected their quality of life immediately after completing radiation therapy and again at six, 12 and 24 months after treatment. Researchers then compared changes in patients' EPIC scores over the study period.