Adjuvant RT May Cut Recurrence in Some With Prostate Cancer

Adjuvant radiotherapy after radical prostatectomy compared with surgery alone may prolong biochemical recurrence-free survival in patients with locally advanced prostate cancer, according to a study published online in European Urology.

Greetta Hackman, of the University of Helsinki, and colleagues recruited a total of 250 patients at eight hospitals in Finland who had either pT2 prostate cancer with positive margins or pT3a, pN0, M0 cancer regardless of margins. Patients were randomly assigned to an adjuvant radiotherapy or observation group. The adjuvant radiotherapy group received a radiation dose of 66.6 Gy. The median follow-up time was 9.3 years for patients in the adjuvant radiotherapy group and 8.6 years for patients in the observation group.

The researchers found that the group receiving adjuvant radiotherapy had a higher 10-year recurrence-free survival rate than the observation group (82 versus 61 percent; hazard ratio, 0.26; 95 percent confidence interval [CI], 0.14 to 0.48; P < 0.001). Overall survival rates were similar, at 92 percent for the adjuvant radiotherapy group and 87 percent for the observation group (hazard ratio, 0.69; 95 percent CI, 0.29 to 1.60; P = 0.4). However, 56 percent of patients who received radiotherapy experienced grade 3 adverse events compared with 40 percent in the observation group, and one patient in the adjuvant radiotherapy group experienced a grade 4 adverse event.

"More treatment also means more side effects," Hackman said in a statement. "However, at the same time, we can likely influence the disease's prognosis in a situation in which the cancerous tissue already extends to the prostate's surface or has penetrated through the prostate's capsule, but has not yet metastasized."

Several authors disclosed financial ties to the pharmaceutical industry.

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