ASCO--In an EORTC study, the combination of radiotherapy and adjuvant
hormonal therapy with an LHRH analog has been shown to significantly
increase survival in patients with locally advanced prostate cancer,
compared with radiotherapy alone.
Michel Bolla, MD, of the University Joseph Fourier Grenoble, representing
the EORTC's Radiotherapy and Genitourinary Tract Cancer Cooperative
Groups, presented the data at a scientific session of the American
Society of Clinical Oncology meeting.
Dr. Bolla pointed out that the results, though promising, are
preliminary and need to be confirmed by longer follow-up. Median
follow-up to date is only 33 months, he said.
In the study, 415 patients with prostate cancer classified as
T1,T2 WHO grade 3 or T3,T4 with any histologic grade were randomized
to receive radiotherapy alone or radiotherapy plus the LHRH analog
goserelin (Zoladex) given at the start of radiotherapy and continued
for 3 years.
Radiotherapy consisted of 5 weeks of treatment to the whole pelvis
(up to 50 Gy in 20 fractions), followed by a boost to the prostate
and seminal vesicles of 20 Gy for 2 weeks.
Goserelin, 3.6 mg, was given subcutaneously every 4 weeks. To
inhibit a transient rise of testosterone, patients also received
the antiandrogen cyproterone acetate for 1 month, starting at
least 1 week before the first goserelin injection.
Over one third of patients (35%) had a high Gleason score (8 to
10) and at least 30% had baseline PSA levels 10-fold higher than
normal. Patients who failed when receiving radiotherapy alone
were given the option of receiving delayed hormonal therapy.