High-dose radiation therapy better at reducing PCa recurrence

Men with localized prostate cancer who receive high-dose external radiation therapy are less likely to have cancer recurrence than those who receive conventional-dose radiation therapy, according to a randomized study published in JAMA (2005; 294:1233-9).

The study, from Massachusetts General Hospital and Harvard Medical School, Boston, included 393 patients with stage T1b through T2b prostate cancer and PSA levels less than 15.0 ng/mL. Patients received either external beam radiation therapy to a total dose of either 70.2 Gy or 79.2 Gy.

The proportion of men free from biochemical failure at 5 years was 61.4% for conventional-dose and 80.4% for high-dose radiotherapy, a 49% reduction in the risk of failure. There has been no significant difference in overall survival rates between the groups.

"This randomized trial shows that when men with clinically localized prostate cancer are treated with high-dose rather than conventional-dose external radiation therapy, they are more likely to be free from an increasing PSA level 5 years later and less likely to have locally persistent disease," wrote the authors, led by Anthony L. Zietman, MD.