Adjuvant radiation therapy may be more effective at treating prostate cancer than no treatment or salvage radiation therapy, according to a recent study published in BJU International.
Studies have demonstrated that adjuvant radiation therapy can be effective in patients with a variety of cancer types; however, the effectiveness of different techniques as well as optimal use have not been well established in those with prostate cancer. Therefore a group of German researchers set out to compare the effectiveness of no treatment or salvage radiation therapy at biochemical recurrence versus adjuvant radiation therapy in lymph node-positive patients with prostate cancer after radical prostatectomy.
A total of 773 patients with lymph node-positive prostate cancer after radical prostatectomy were retrospectively analyzed for the study. Researchers led by Derya Tilki, University Hospital Hamburg-Eppendorf, Germany, used cox regressions and propensity score matching to assess how different factors influenced biochemical recurrence and metastasis-free survival.
At 33.8 months median follow-up, researchers found that 4-year biochemical recurrence and metastasis-free survival rates were 43.3% and 86.6%, respectively, for all patients. However, statistical analysis revealed that no treatment and salvage therapy were independent risk factors for biochemical recurrence and metastasis compared with patients who received adjuvant radiation therapy. In addition, Four-year metastasis-free survival in the matched cohort was 82.5% versus 91.8% for the no treatment/salvage therapy and adjuvant radiation therapy groups, respectively. Further, salvage therapy used early was significantly associated with decreased risk of metastasis compared with salvage therapy used only when patients had prostate specific antigen levels greater than 0.5 ng/ml.
From these results, researchers concluded that patients with lymph node-positive prostate cancer who received adjuvant radiation therapy achieved better oncologic outcomes compared with those who received no treatment or were treated with salvage therapy.
