ESMO 2018: Does Local Radiotherapy Improve Survival in Some Men With Prostate Cancer?
Posted: Friday, November 2, 2018
Men with metastatic prostate cancer and a low disease burden may reap survival benefits from local radiotherapy, reported a new study at the European Society for Medical Oncology (ESMO) 2018 Congress in Munich (Abstract LBA5_PR). Results from the STAMPEDE phase III trial found that radiotherapy to the prostate improved failure-free survival among all patients, but overall survival improved only among men with a lower metastatic disease burden (not among those with a higher disease burden).
“Prostate radiotherapy, in addition to drug treatment, should now be a standard treatment option for men with oligometastatic disease,” Chris Parker, MD, of The Royal Marsden NHS Foundation Trust, Sutton, United Kingdom, stated in an ESMO press release.
The authors randomly assigned 2,061 men with newly diagnosed metastatic prostate cancer from the UK and Switzerland 1:1 to receive lifelong androgen-deprivation therapy (ADT) plus early docetaxel or ADT plus radiotherapy. Patients with prostate cancer had a higher disease burden if they had four or more bone metastases with at least one outside the axial skeleton and/or visceral metastases.
Local radiotherapy improved failure-free survival among all patients. Overall survival rates improved by 32% in the 819 men with a lower metastatic burden treated with radiotherapy, but no improvement was observed in the 1,120 with a higher metastatic burden. Local radiotherapy was well tolerated in the combination group—5% of patients experienced severe adverse events during treatment and 4% after treatment. “There was a small increase in [the] risk of bladder and bowel side effects, but these [effects] were modest,” commented Dr. Parker. “The side effects are certainly outweighed by the survival benefit.”
