Study shows lasting benefit of radiotherapy after surgery in prostate cancer

by Bruce Sylvester – taken from The Lancet – Radiotherapy given immediately after prostate removal surgery has a long-term benefit of preventing  progression of the disease, researchers reported in a study published online  on Oct 18, 2012 in The Lancet.

After 10 years, 61% of subjects who received immediate radiotherapy treatment remained disease-free compared with 38% of those who did not receive immediate radiotherapy, according to a follow-up study of the randomized EORTC trial 2291.

“These long-term results reassure us of the continued benefit and safety of radiation therapy after prostatectomy for a large proportion of men with locally advanced or high-risk prostate cancer,” said Michel Bolla, MD, Centre Hospitalier Universitaire  A. Michallon, Grenoble, France. “They also suggest that younger patients and those with positive surgical margins are most likely to benefit from immediate radiotherapy, whereas in older adults [aged ≥70 years], it could have detrimental effects.

Dr. Bolla and his team tracked 1,005 subjects with high-risk prostate cancer for more than 10 years. They evaluated  therapeutic effects of immediate postoperative radiotherapy (within 4 months of surgery) versus watchful waiting until first signs of disease recurrence.

Even after 10 years, the subjects who received immediate radiotherapy had significantly better biochemical progression-free survival compared with those who were only monitored. And there was no significant difference in severe toxicity. The immediately-treated subjects also achieved substantially better local control and were less likely to need hormonal therapy.

Unlike the 5 year results, clinical progression-free survival was not significantly improved with immediate radiation therapy after 10 years, and radiotherapy had no effect on the 10-year rates of distant cancerous spread or overall survival.