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Escalated radiotherapy benefits prostate cancer sufferers

Men with localised prostate cancer are best treated with a radiotherapy regime that involves higher doses of radiation, research suggests.

The 10-year trial, which is the largest of its kind ever conducted, shows that having 37 rounds, or fractions, of radiotherapy at 74 Gray (Gy) – compared with 32 fractions at 64 Gy - controlled the disease more effectively.

Doing so also reduced the chance that men would need follow-up hormone-deprivation therapy, which can have long-term side-effects.

The RT01 phase III trial was led by Professor David Dearnaley, from the Institute of Cancer Research in London, and involved experts from several leading clinical research centres in the UK, New Zealand and Australia.

“Treating men with localised prostate cancer using higher doses of radiotherapy is more effective”

Professor David Dearnaley

Set up in 1998, the study split 843 men with localised prostate cancer into two groups to compare the two doses of radiotherapy. Some 421 of them had the less intensive treatment regimes, while 422 had the more intensive ones.

All of the participants also had standard hormone-deprivation treatment alongside their radiotherapy.

David Dearnaley

Professor David Dearnaley

Men who received the higher dose were more likely to have side-effects associated with radiotherapy, but few men had severe side-effects, while receiving the higher dose reduced the need for follow-up hormone treatment.

The trial did not show that men given dose-escalated radiotherapy live longer, but both groups of men lived much longer than expected. Almost three quarters of all the men in the study were still alive after 10 years, and of the 236 men who had died since treatment, only 91 had died of prostate cancer.

“Our study has proved that treating men with localised prostate cancer using higher doses of radiotherapy is more effective than a less intensive regime,” said Professor Dearnaley.

“The dose-escalated regime is safe in the long term, and reduces the chances that a cancer will return and men will require further hormone-deprivation treatment.”

 

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