PSA Failure Less Likely with EBRT than Cryotherapy for Locally Advanced PCa

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MONTREAL—Patients with locally advanced prostate cancer (PCa) have significantly better long-term biochemical disease-free survival (bDFS) if they are treated with external beam radiation therapy (EBRT) rather than cryoablation, Canadian researchers reported.

The study, by researchers at London Health Sciences Centre, University of Western Ontario, London, based their findings on data from 62 patients with locally advanced prostate cancer who completed a randomized trial comparing the two treatments, with median follow-up of 105.2 months. In the trial, the eight-year bDFS rate was 17.4% among patients treated with cryoablation and 59.1% among those treated with EBRT. The median time to biochemical failure was similar for both treatment groups, as were cancer-specific survival and overall survival.

In the study, which was led by Joseph Chin, MD, and presented at the Canadian Urological Association annual meeting by Ali Al-Zahrani, MD, all men received neoadjuvant hormonal therapy for three months prior to cryoablation or EBRT and for three months afterward. The investigators defined biochemical failure using Phoenix criteria (PSA nadir plus 2 ng/mL). 

The investigators concluded that cryoablation might be more suited for less bulky prostate tumors. In addition, a longer neoadjuvant hormone deprivation period appears to be required for optimal bDFS.

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