Early Adjuvant Radiotherapy Benefits Selected Prostate Cancer Patients

Radiotherapy given within 6 months of radical prostatectomy reduces cancer-specific mortality.
Radiotherapy given within 6 months of radical prostatectomy reduces cancer-specific mortality.

Men with highly aggressive prostate cancer (PCa) who receive early radiotherapy after radical prostatectomy experience significantly improved cancer-specific survival, new study findings suggest.

The study, led by Giorgio Gandaglia, MD, of the University of Montreal Health Center in Montreal, Canada, included 7,616 patients with pT3/4 N0/1 PCa who underwent radical prostatectomy (RP) from 1995 to 2009. The researchers stratified patients according to risk scores based on the number and nature of adverse pathologic characteristics (Gleason score 8–10, pT3b/4, and lymph node invasion).

Among patients with 2 or more of these characteristics (that is, a risk score of 2 or higher), the 10-year cancer-specific mortality rates were significantly lower for those having early radiotherapy (within 6 months of RP) than men not receiving early radiotherapy (6.9% vs. 16.2%), Dr. Gandaglia and his colleagues reported online ahead of print in the International Journal of Urology.

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In addition, the investigators calculated that 10 patients with a risk score of 2 or higher would need to be treated with early radiotherapy to prevent 1 cancer-specific death at 10-year follow-up.

Early radiotherapy was not associated with lower cancer-specific mortality rates overall and in men with risk scores less than 2.

The investigators concluded that their findings confirm the validity of a previously developed risk score in selecting the best candidates for adjuvant radiotherapy after RP in a large contemporary population-based cohort of patients with pT3/4 N0/1 PCa.

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