Studies have shown so far that the most common cancer among the male folks in America is Prostate cancer. Every year about 180,000 men are diagnosed, and about 95 percent of them have localised disease that is potentially curable. In the past, research has always established that conventionally fractionated high dose external beam radiation therapy (CRT), which is made up of daily treatment for a period of two months, reduces prostate cancer recurrence, while enhancing metastasis-free survival.
Also, initial research efforts make obvious the fact that moderate hypo-fractionated radiation therapy (HRT), made up of day-to-day therapy for a month period, applying a larger dose for each treatment, gives the same type of low risk of recurrence. It as well shows that it may even be further reduced with HRT than CRT.
For a perfect test of the hypothesis of a lower risk of recurrence with HRT, a recent research led by a team of scientists at Brigham and Women’s Hospital published in European Urology Focus, carried out a systematic review and meta-analysis. They brought together available data, to measure whether an improved risk of recurrence is possible through the use of HRT as compared with CRT, in addition to measuring the relative impact of these two treatments on bladder and rectal function.
To this end, scientists discovered that the one-month period HRT, was linked with great progress seen in recurrence compared to the two-month duration CRT, thereby making a lot of sense to consider in men who have intermediate risk prostate cancer, and having no risk factors that could make the patient susceptible to bladder side effects even after many years after therapy has been completely carried out.
To this, Trevor Royce, MD, MPH, radiation oncologist at Brigham and Women’s Hospital and first author of the study remarked: “Our results provide evidence for clinicians to consider HRT as compared with CRT as a preferred radiation treatment in men with intermediate-risk prostate cancer and at low risk of other complications.” He further stated that, “treatment with a shorter course of radiation and higher doses over fewer days may be the preferred approach in appropriately selected patients with localised prostate cancer, reducing treatment time and cost to the patient, and increasing patient convenience and access to treatment.”
The study team analysed data from over 5,000 men taken from three randomised research works which compare HRT with CRT in men with prostate cancer. Out of the 5,484 men, 3,553 men, being 64.8 percent of them were found with intermediate-risk prostate cancer. HRT when compared with CRT was linked with a rather high 13 percent decrease in the possibility of recurrence. There was no meaningful difference in survival generally seen between HRT and CRT; rather scientists inform that there is a chance of excellently healthy men also achieving a general survival advantage with HRT in comparison with CRT.
Considering all of these, Anthony D’Amico, MD, PhD, chief, Genitourinary Radiation Oncology at Brigham and Women’s Hospital, and senior author of the study, disclosed that, “Late bladder and urethra toxicities were noted to be higher in the HRT as compared to CRT group which necessitates carefully choosing men who are not at risk for sustaining a late bladder or urethral side effect.” He added that, “men to exclude would be those who get up more than three times at night to urinate, or have urgency to urinate, or incontinence, or men who are on anti-coagulants that could increase the risk of bleeding.”
Meanwhile, the scientists urge that more research would be necessary – using individual patient-level data among men with high risk prostate cancer in order to measure the gains of HRT and also find out treatment toxicity, chiefly those to the bladder and urinary system which are as well low in the HRT.