Prolonged survival for older men with prostate cancer
Prolonged survival for older men with prostate cancer
5 Jan 2015Adding radiation treatment to hormone therapy, reduced cancer deaths by nearly 50% in men aged 76 to 85 compared to men who only received hormone therapy, according to a new study published in the Journal of Clinical Oncology this week.
An innovative study addressing a failure gap in the treatment of older patients
According to the lead study author Justin E. Bekelman, MD, an assistant professor of Radiation Oncology, Medical Ethics and Health Policy at Penn's Perelman School of Medicine and Abramson Cancer Center, radiation plus hormonal treatment is an effective treatment for older patients with aggressive prostate cancer, responding to the need for such treatments in the United States health care system. As previous studies have shown, only 40% of men with aggressive prostate cancers are treated with hormone therapy alone, exposing a large gap in curative cancer care among older men. Two landmark clinical trials of radiation plus hormone treatment have shown the significant improvement in younger men, but until now there has been no comparable research on treatment for older men with advanced prostate cancer.
Clinical outcome: 1/3 fewer deaths
Penn's research team compared the combination of radiation plus hormone therapy versus hormone therapy alone among 31,541 men with prostate cancer ranging in age from 65 years to 85 years.
- Among men aged 65 to 75 years old, radiation plus hormone treatment was associated with a reduction in prostate cancer deaths of 57% relative to hormone treatment alone.
- Similarly, among men aged 76 to 85 years old, radiation plus hormone treatment was associated with a reduction in prostate cancer deaths of 49% relative to hormone treatment alone.
In both groups, radiation plus hormone treatment was also associated with about 1/3 fewer deaths from any cause.
Patients received treatments not by random assignment but as part of their normal clinical care. Bekelman's team utilized specialized analysis techniques to mimic randomized clinical trials in data from routine care and to identify which treatments are best for men of different age groups and cancer severity.
Tolerable clinical side effects, according to study author
Importantly, the clinical trials have shown that the side effects of radiation plus hormonal therapy are very acceptable relative to hormonal therapy alone. "Older men with aggressive prostate cancers should know that the combination of radiation plus hormone therapy is both tolerable and effective in curing prostate cancer," said Bekelman.
Helping patients participating in cancer care decisions
In addition to offering new evidence for older men, Bekelman's research also demonstrates that the prior clinical trial findings for younger men apply in the "real-world" of routine clinical practice. Only 3% of cancer patients participate in clinical trials; thus, confirming that treatments work in real-world care is a crucial aspect of translating medical evidence to clinical practice. Bekelman's study is an example of patient-centered cancer comparative effectiveness research, offering useful information to help individual patients make informed cancer care decisions and improve cancer care outcomes.
Source: Science Daily