October 27, 2021
Fewer radiation treatments at higher doses following surgery may be a safe and effective treatment option for people with prostate cancer, according to new clinical trial data.
The study by the American Society for Radiation Oncology found that men who had radiation regimens of five weeks instead of seven weeks, saw positive results while not increasing their risks of long-term side effects. Prostate cancer is highly treatable when caught early enough. In the United States, the 10-year survival rate is 98%.
Undergoing fewer radiation treatments after surgery can be desirable for prostate cancer patients for many reasons, especially convenience. But Dr. Neha Vapiwala, a radiation oncologist at the University of Pennsylvania, told U.S. News & World Report that the safety of a shorter regimen has been a major concern among doctors and patients. She was not involved in the study.
Vapiwala did say that these new findings offer "level-one evidence" that a shorter course with higher doses can be delivered safely.
In the trial, the men who were assigned to higher-dose regimens had more gastrointestinal symptoms, such as cramps, diarrhea and nausea, than those assigned to traditional courses of radiation. However, these symptoms had been completely resolved in both groups before their six-month follow-up appointments.
Additionally, urinary problems which can occur after radiation, like leakage or burning during urination, do not appear to increase among patients given the higher-dose regimens – neither in the short term nor in the two years after treatment.
"Preserving quality of life was a major priority when testing the shorter treatment course," lead researcher Dr. Mark Buyyounouski said. "It is important for patients to know that accepting a more convenient treatment doesn't mean they have to compromise on quality of life."
Buyyounouski said shorter treatment courses could also lessen the time patients need to take from work, as well as reduce their travel expenses and co-pays.
The study involved 296 men at more than 90 centers in North America who had undergone surgery for prostate cancer and needed follow-up radiation. Around half of the participants were randomly assigned to receive standard doses over seven weeks, while the rest were given higher doses over five weeks.
"Short-term side effects of radiation therapy are well-established, and patients understand that," Buyyounouski, a professor of radiation oncology at Stanford University School of Medicine, said. "What patients ultimately want to know is whether the side effects will go away, and that's what we saw in our study."
The idea of prostate cancer patients being treated with shorter radiation courses is not new. For some men it is an option instead of surgery, but it has not been frequently offered to men who do have surgery first.
The findings were presented at the annual meeting of the American Society for Radiation Oncology. The data is considered preliminary until it is published in a peer-reviewed journal.