1: High dose radiation as effective as radical prostatectomy for aggressive prostate cancer
In a study published this month in the European Journal of Urology, researchers from UCLA performed a retrospective analysis to compare the outcomes for 487 men with Gleason scores of 9 or 10 treated with either radiation or surgery. Clinical outcomes were measured for men treated between 2000-2013 with either EBRT (extremely-dose escalated radiotherapy) [230 men], EBRT + BT (Brachytherapy) [87 men] or RP (radical prostatectomy) [170 men], with a median follow-up of 4.6 years.
While 5-yr and 10-yr cancer specific survival and overall survival was similar for all three treatment groups, there was a significant increase in 5-yr and 10-yr distant metastasis-free survival in men who received EBRT + BT (94.6%, 89.8%) compared to EBRT alone (78.7%, 66.7%, p<0.0005) or RP (79.1%, 61.5%, p<0.0001). In addition, there was increased local and systemic salvage associated with RP (49.0%, 30.1%) compared to EBRT (0.9%, 19.7%) or EBRT + BT (1.2%, 16.1%, p<0.001).
This study provides both clinicians and patients with more evidence about the efficiency of these common treatments and indicates that while both radiation and surgery are effective treatments for aggressive prostate cancer, EBRT + BT may provide the best chance of preventing metastatic disease.