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(Drug information on 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(Drug information on 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.