Palliative short-course RT benefits advanced prostate cancer patients

Jun 15, 2009

Patients with advanced hormone refractory prostate cancer who experience troublesome pelvic symptoms can benefit from short-course palliative radiation therapy, according to a study published online in Radiotherapy & Oncology (May 21, 2009). The study is the first to formally report on the effectiveness of short-course hypofractionated radiation therapy for this use.

A multidisciplinary team of urologists and oncologists from Weston Park Hospital in Sheffield, U.K., retrospectively evaluated the outcomes of patients treated for pelvic pain, urinary obstruction, hematuria, and rectal obstructive symptoms with short-course radiation therapy between 2003 and 2007 to quantify symptomatic benefit.

The cohort initially consisted of 58 patients, all of whom had advanced prostate cancer and 27 had metastatic disease at the time of treatment. All but two of the patients received 20 Gy of palliative radiotherapy in five fractions. One patient received 12.5 Gy in five fractions, and another patient received 10 Gy in a single fraction.

Patients were routinely evaluated at six weeks, four months, and seven months after treatment. At the time of the four-month evaluation, 12 patients were lost to follow-up and 11 had died.

The researchers assessed the treatment outcomes of the remaining 35 patients, or 60% of the original group, at four months following treatment. Thirty-one patients, or 89%, had a complete (20 patients) or partial (11 patients) resolution of symptoms. Symptoms stabilized for two patients. The radiation therapy treatment had no benefit for two patients, whose symptoms continued to worsen.

The radiation therapy was most effective treating hematuria, according to lead author and clinical oncology research fellow Dr. Omar Din. None of the patients experienced any toxicities after the six weeks follow-up. Only 13% of the patients who were evaluated at six weeks experienced mild toxicities and 9% experienced moderate toxicities.

The researchers compared the symptomatic outcomes of their patients with several previously published studies that used high-dose palliative radiotherapy with similar patient cohorts. They believe that the treatment outcomes of their patients were similar enough to merit formal prospective clinical trials to compare the use of short-course radiation therapy with other types of therapies being used for palliative treatment of the pelvic symptoms of patients with advanced prostate cancer.

Radiation added to hormone therapy beneficial in locally advanced prostate cancer, March 31, 2008