Shorter Treatment Yields Similar Disease-free Survival Rate for Some Prostate Cancer Patients

By Hannah Stuart
Friday, April 1, 2016

For certain prostate cancer patients, a shorter radiation therapy (RT) treatment protocol has produced results comparable to those generated by longer treatments.

A study comparing the five-year disease-free survival rate of men with low-risk prostate cancer who received hypofractionated RT versus that of men who underwent standard RT has concluded that hypofractionated treatment is at least as good as the longer treatment. The findings were presented at the 2015 meeting of the American Society for Radiation Oncology.

In the study, conventional RT was delivered to one group of men over a period of 8.2 weeks; hypofractionated RT was administered to another group over a period of 5.6 weeks. Survival outcomes were similar, says researcher Deborah Watkins Bruner, PhD, RN, FAAN, Robert W. Woodruff Chair in Nursing Professor, Associate Director of Outcomes Research, Neil Hodgson Woodruff School of Nursing at Emory University. The five-year disease-free survival rate for those who received conventional therapy was 85 percent; the rate for those who received hypofractionated therapy was 86 percent.

“We want to be sure if we’re doing less treatment that it’s not inferior to the longer course of therapy in terms of survival,” Watkins Bruner says, “and it’s not, so that’s extremely important.”

Quality-of-life Considerations

Researchers were still analyzing whether side effects — such as impact on bowel and bladder function — were similar between those who received hypofractionated RT and those who received conventional treatment. If they do not find significant loss in quality of life, benefits of hypofractionated RT could include reduced travel time and related discomfort for patients due to fewer overall visits, as well as reduced costs to patients and health systems, Watkins Bruner says.

“In general, radiotherapy is moving quite rapidly toward shorter courses ...,” says Daniel Low, PhD, Vice Chair of Medical Physics in the Department of Radiation Oncology at the University of California, Los Angeles, who was also involved in the study. “So radiotherapy is becoming less and less the seven- to eight-week treatment that it historically has been. In many cases like this, it’s equivalent to the longer course, and in some cases, it’s superior to the longer course.”

Other research seems to support that view. A 2013 article in Reviews in Urology found that with regard to localized prostate cancer, hypofractionated radiation therapy “appears to have similar and often less acute and late toxicities than conventionally fractionated radiotherapy.”