Surgery has greater impact on urinary function;......radiation therapy, on bowel function
Atlanta-Radical retropubic prostatectomy and external beam radiation therapy (XRT) show no significant difference in efficacy outcomes in men with clinically localized prostate cancer, according to findings from an interim phase III analysis from Italy. In terms of health-related quality of life, XRT offers a slight edge on some, but not all, measures, researchers reported at the American Society of Clinical Oncology annual meeting here.
Patients were recruited between January 1997 and September 2001, and 137 patients were randomized to undergo either retropubic RP or XRT. They were followed for a median of 67 months. Data were analyzed on an intent-to-treat basis.
No significant differences in clinical disease progression and survival rates were observed between surgery and radiation therapy, reported first author Savino Mauro Di Stasi, MD, PhD, associate professor of urology of Tor Vergata University in Rome. At median follow-up, 32.8% of the patients had evidence of biochemical disease progression: 32.8% in the XRT group and 31.4% in the prostatectomy group. The median time to biochemical failure was 55.5 months among patients undergoing surgery versus 56 months for those receiving XRT.
Prostate cancer-related deaths were observed in 4.3% and 1.5% of the surgery and radiation therapy patients, respectively.
Quality of life differences
Before treatment and after 1, 3, 6, 12, and 24 months, 47 patients in the prostatectomy group and 49 in the XRT group completed a questionnaire assessing their general health-related quality of life (Functional Assessment of Cancer Therapy-General [FACT-G]) and specific changes in urinary, bowel, and sexual functions (UCLA Prostate Cancer Index [UCLA-PCI]).
"A larger sample size accrual and long-term follow-up data are warranted to confirm these results," the researchers noted.
"These represent interim findings, and it is difficult to make a definitive statement about the efficacy of treatment," Dr. Di Stasi told Urology Times. "However, there were obvious differences in quality of life in the treatment groups, and these findings can help serve as a discussion point for patients deciding upon a treatment."