The results of a large trial have shown that treating men with high-risk prostate cancer with external-beam radiotherapy in addition to hormone therapy improves survival, compared to hormone therapy alone. These results are important as there are over 10,000 deaths from prostate cancer each year in the UK alone.
The randomised controlled trial, known in the UK as MRC PR07, recruited patients between 1995 and 2005. It involved 1,205 patients with locally-advanced prostate cancer (which had grown outside the surface of the prostate but had not spread further). Half were treated with hormone therapy and the other half were treated with a combination of the same hormone therapy and a course of radiotherapy.
The researchers found that 74 per cent of men who received both radiotherapy and hormone therapy were still alive after seven years, compared with 66 per cent of those who did not receive radiotherapy. The study also showed that those who received radiotherapy were about half as likely to die from their disease. The additional side-effects from the radiotherapy given in the trial were minimal.
Radiotherapy with hormone therapy is a common approach to treating locally-advanced prostate cancer. However, some men with locally-advanced prostate cancer are treated with hormone therapy alone. The evidence now available shows that radiotherapy (given in addition to hormone therapy) does improve survival, so this should be the standard of care for these men.
The Lancet published these results in November 2011. The implications of these results for treating men with locally-advanced prostate cancer are discussed in a policy brief.
The PR07 trial results provide strong evidence that using a combination of radiotherapy and hormone therapy can improve the survival of men with locally advanced prostate cancer.
However, there are still many questions about what the optimal treatment strategies are for prostate cancer. Ongoing clinical trials are essential to answering these questions. For example, the STAMPEDE trial is examining how to further improve survival in men starting long-term hormone therapy (including men like those in PR07 and who are having radiotherapy) by adding one or two of four new drugs; the PATCH trial is examining alternative methods of providing hormone therapy to the same group of men; the RADICALS trial is examining the best timing of radiotherapy in men who have had prostate surgery.
The PR07 trial registration number is ISRCTN24991896.