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Shorter, intensive radiation can be recommended in early prostate cancer

Date:
April 4, 2016
Source:
Duke Health
Summary:
Giving early-stage prostate cancer patients a slightly higher daily dose of radiation can cut more than two weeks from the current treatment regimen without compromising cancer control, according to an American national study.
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Giving early-stage prostate cancer patients a slightly higher daily dose of radiation can cut more than two weeks from the current treatment regimen without compromising cancer control, according to a national study led by a Duke Cancer Institute researcher.

Publishing April 4 in the Journal of Clinical Oncology, the research team compared the shortened radiation therapy schedule of about 5.5 weeks to the standard 8-week regimen to determine if rates of cure were similar. Both treatment schedules were similar in terms of controlling cancer, but doctors reported slightly more mild side effects in patients getting the shorter radiation schedule.

"This study has implications for public policy," said the study's principal investigator, W. Robert Lee, M.D., a professor in the Department of Radiation Oncology at Duke. "Because the shorter regimen has advantages such as greater patient convenience and lower costs, it's important to establishing whether we can cure as many patients with the shorter regimen. Our study provides that information for the first time."

Lee and colleagues, working as part of NRG Oncology, a non-profit cancer research organization, enrolled about 1,100 men whose prostate cancer was diagnosed early, before it had spread. Roughly half the patients were randomly assigned to receive the typical regimen of 41 treatments; the other half received the higher dose over just 28 treatments.

At five years, disease-free survival was no different between the two groups, with 85.3 percent of men in the traditional group being cancer-free, compared to 86.3 percent of men in the shorter regimen group. Overall survival at five years was also no different, at 93.2 percent and 92.5 percent respectively.

Mild gastrointestinal and genitourinary toxicity as reported by doctors was observed more frequently in patients getting the higher daily dose, shorter frequency radiation, but no differences were observed in more severe side effects, which were rare (less than 5 percent) with either regimen. The researchers also asked patients to describe their own experiences of side-effects, but these data have yet to be analyzed.

"An estimated 220,000 men are expected to be newly diagnosed with prostate cancer each year in the United States, and the majority will have early-stage disease at low risk for recurrence," Lee said. "These findings should help guide clinical decisions, and doctors should be comfortable recommending a shorter radiotherapy course as an alternative to the conventional schedule."


Story Source:

Materials provided by Duke Health. Note: Content may be edited for style and length.


Journal Reference:

  1. W. R. Lee, J. J. Dignam, M. B. Amin, D. W. Bruner, D. Low, G. P. Swanson, A. B. Shah, D. P. DSouza, J. M. Michalski, I. S. Dayes, S. A. Seaward, W. A. Hall, P. L. Nguyen, T. M. Pisansky, S. L. Faria, Y. Chen, B. F. Koontz, R. Paulus, H. M. Sandler. Randomized Phase III Noninferiority Study Comparing Two Radiotherapy Fractionation Schedules in Patients With Low-Risk Prostate Cancer. Journal of Clinical Oncology, 2016; DOI: 10.1200/JCO.2016.67.0448

Cite This Page:

Duke Health. "Shorter, intensive radiation can be recommended in early prostate cancer." ScienceDaily. ScienceDaily, 4 April 2016. <www.sciencedaily.com/releases/2016/04/160404170423.htm>.
Duke Health. (2016, April 4). Shorter, intensive radiation can be recommended in early prostate cancer. ScienceDaily. Retrieved May 23, 2017 from www.sciencedaily.com/releases/2016/04/160404170423.htm
Duke Health. "Shorter, intensive radiation can be recommended in early prostate cancer." ScienceDaily. www.sciencedaily.com/releases/2016/04/160404170423.htm (accessed May 23, 2017).

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