NEW YORK (Reuters Health) - Adding just 6 months of androgen suppression
therapy (AST) to radiotherapy can improve the survival of patients with
clinically localized prostate cancer, according to a report in the
Journal of the American Medical Association for August 18th.
Although 3 years of AST, in combination with radiotherapy, has been
shown to improve survival, such long-term therapy has many adverse
effects, lead author Dr. Anthony V. D'Amico, from Brigham and Women's
Hospital in Boston, and colleagues note. Shorter-term AST therapy could
reduce the adverse effects, but it was unclear if a survival benefit
would still be observed.
To investigate, the researchers assessed the outcomes of 206 patients
with clinically localized prostate cancer who were randomized to receive
70 Gy radiation therapy alone or in combination with 6 months of AST.
The median follow-up period was 4.52 years.
Compared with radiotherapy alone, radiotherapy plus AST was associated
with longer survival, lower prostate cancer-specific mortality, and
longer survival without needing salvage AST (p < 0.05 for all), the
investigators note.
The 5-year survival rates in the combination therapy and radiation only
groups were 88% and 78%, respectively. The corresponding rates of
survival without needing salvage AST were 82% and 57%.
So, AST provides a survival benefit if given for only 6 months, but is
this benefit comparable to that seen with long-term AST? A European
study addressing that question has just finished, but the results have
not yet been reported, the investigators note.
In a related editorial, Dr. Theodore L. DeWeese, from The Johns Hopkins
University School of Medicine in Baltimore, comments that the current
study is "important particularly in that it is the first to demonstrate
a survival benefit when AST is added to radiation therapy in the
management of patients with clinically localized prostate cancer."
JAMA 2004;292:821-827,864-866.

knowledge is power - growing old is mandatory - growing wise is optional    
"Many more men die with prostate cancer than of it. Growing old is
invariably fatal. Prostate cancer is only sometimes so."