Main Treatment Options for Prostate Cancer Have Same Cure Rates

Newswise — Cure rates are just about equal for prostate cancer patients treated with surgery, radiation, permanent seed implants and permanent seed implants combined with radiation therapy, according to a new study in the January 2004 issue of the International Journal of Radiation Oncology·Biology·Physics, the official journal of ASTRO, the American Society for Therapeutic Radiology and Oncology.

With many potentially curative therapies available to patients newly diagnosed with localized prostate cancer, it is understandable that there is some confusion for the patient. For the past 15 years, radical prostatectomy, various forms of external beam radiotherapy and brachytherapy have all been promoted as reasonable options for treatments. The goal of this study was to review the biochemical relapse-free survival rates after treatment with permanent seed implants, low-dose external beam radiation therapy, high-dose external beam radiation therapy, combined seeds and external beam radiation therapy, or surgery for clinical stage T1 and T2 localized prostate cancer.

The study included 2,991 consecutively treated patients with clinical stage T1 and T2 adenocarcinoma of the prostate, treated with surgery, low-dose external beam radiation therapy, high-dose radiation therapy, permanent seed implants or combined seeds/external beam radiation therapy. Of the 2,991 patients treated between 1990 and 1998, 1,973 of the patients were treated at Cleveland Clinic Foundation and 1,018 were treated at Memorial Sloan Kettering at Mercy Medical Center. All patients had available pretreatment PSA levels and biopsy Gleason scores. Each patient was followed for a minimum of 12 months after therapy.

The results of the study showed that the biochemical failure rates or cure rates were similar among permanent seed implantation, high-dose external beam radiotherapy, combined seed/external beam radiotherapy and surgery for localized prostate cancer. The outcomes were significantly worse for patients treated with low-dose external beam radiotherapy.

“This study represents the largest published series comparing the most frequently used therapies for patients with clinically localized prostate cancer,” said Patrick A. Kupelian, M.D., the lead author of the study and a member of the Department of Radiation Oncology at M.D. Anderson Cancer Center Orlando in Orlando, Fla. “The results show that survival rates are pretty much the same for patients treated with surgery, high-dose external beam radiation therapy, permanent seed implants and a combination of permanent seed implants and external beam radiation therapy. We hope that this study will help men newly diagnosed with prostate cancer and their families evaluate the treatment options to make the best treatment choice for their cancer and lifestyle.”

The American Society for Therapeutic Radiology and Oncology is the largest radiation oncology society in the world, with more than 7,500 members who specialize in treating patients with radiation therapies. As a leading organization in radiation oncology, biology and physics, the Society’s mission is to advance the practice of radiation oncology by promoting excellence in patient care, providing opportunities for educational and professional development, promoting research and disseminating research results and representing radiation oncology in a rapidly evolving socioeconomic healthcare environment.