Long Term Hormone Therapy Beneficial to Prostate Cancer Patients
This report was reviewed for medical and scientific accuracy by Donald J. Filip, MD , Medical Oncology, Private Practice, Atlanta, Georgia.
A study presented at the recent American Society of Clinical Oncologists showed that patients with locally advanced prostate cancer (i.e., cancer that extends outside the prostate gland) can live longer and have a lower risk of recurrence if they are treated with 28 months of hormone therapy after radiation. Prior to this study, the practice was to give these men only four months of hormone therapy.
"Our results set a new standard of treatment for locally advanced prostate cancer. In addition to controlling recurrence, the use of long-term androgen suppression-with hormone therapy-in this study demonstrated a trend toward the reduction of death due to prostate cancer," stated Gerald E. Hanks, MD, Chairman of Radiation Oncology at Fox Chase Cancer Center, Philadelphia, PA.
The study population included 1,520 men who were followed for an average of 4.8 years. All patients received four months of hormonal therapy with the drugs goserelin acetate (Zoladex®) and flutamide (Eulexin®), two months before radiation and two months during radiation. These drugs suppress production of the hormone androgen, which is known to be involved in the development and spread of prostate cancer. Patients were then randomized to receive either no further hormone therapy or 24 months of additional goserelin acetate alone.
Patients treated with long-term hormonal therapy had a significantly better outcome compared to those who received only four months of hormone therapy. At almost five years of follow-up, 54 percent of patients in the long-term group were alive and free of disease compared to the 34 percent who were taking short- term hormone therapy. Six percent were free of local progression versus 13 percent, respectively; 16 percent and ten percent, respectively, were free of metastasis. Fifty-four patients died of prostate cancer in the short-term hormone therapy group versus 33 in the long-term treatment group.
Results of long-term hormonal treatment were especially impressive in men with a high risk of relapse (i.e., those with a Gleason score of eight to ten). In this group, 80 percent were alive at five years versus 69 percent of those receiving short-term therapy. In the high-risk group, 12 men died in the long-term group compared with 29 in the short-term group.