Cure
rates for surgery and several types of radiation therapy are similar
for patients with localized prostate cancer
Cure rates at 1 year are similar for localized
prostate cancer treated with radical prostatectomy, high-dose external
radiation, or regimens including seed implantation, but the cure
rate is significantly decreased with low-dose external radiation,
according to an article in the January issue of the International
Journal of Radiation Oncology Biology Physics.
With many potentially curative therapies
available to patients newly diagnosed with localized prostate cancer,
some patients find it difficult to make decisions regarding choice
of therapy. For the past 15 years, radical prostatectomy, various
forms of external beam radiotherapy and brachytherapy have all been
promoted as reasonable options.
The goal of the current study was to review
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 or T2 localized
prostate cancer.
American researchers evaluated records for
2,991 consecutive patients with clinical stage T1 or T2 adenocarcinoma
of the prostate who were treated with surgery, low-dose external
beam radiation therapy, high-dose radiation therapy, permanent seed
implants or combined seeds/external beam radiation therapy. Pretreatment
prostate-specific antigen levels and biopsy Gleason scores were
available for all patients. Each patient was followed for a minimum
of 12 months after completion of therapy.
Biochemical cure rates were similar among
permanent seed implantation, high-dose external beam radiotherapy,
combined seed/external beam radiotherapy and surgery. 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,
MD, lead author of the study. “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.”
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