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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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