Combining radiation therapy with hormone therapy improves survival for people over 75 with prostate cancer
Children are often excluded from studies evaluating the efficacy and safety of new treatments. Same thing at the other end of life. People over 75 are also poorly represented in drug research. An American study published Monday in the Journal of Clinical Oncology provides a fine example in prostate cancer. And especially in locally advanced prostate cancer. It is an aggressive cancer that has spread outside the prostate but close to the gland. It is prone to the development of metastases and the risk of death. In Europe and the United States, the recommendations are clear for treating this type of cancer. Radiotherapy must be combined with hormone therapy. Using only hormone therapy is less effective, as three large studies have shown. But can these results apply to older patients who were poorly represented in these studies? Justin Bekelman of the University of Pennsylvania and his colleagues wanted to answer this question.
Few elderly patients treated
A legitimate question since, according to some studies, 67% of patients over the age of 75 with high-risk prostate cancer do not receive any treatment or hormone therapy alone and only 33% are subject to local treatment, as Dean Shumway and Daniel Hamstra of the University of Michigan point out in an editorial accompanying the article.
Justin Bekelman and his colleagues looked at 31,541 men aged 65 to 85 with prostate cancer. For the youngest men (65-75 years), they confirmed in real life the results obtained with very selected patients in clinical trials. Adding radiotherapy to hormone therapy can reduce prostate cancer deaths by 57% compared to hormone therapy alone. But the most interesting result concerns older patients (76 to 85 years old).
A reduction of nearly 50% in mortality
In them too, the decrease in mortality from prostate cancer was 49% lower with dual therapy compared to monotherapy. The death rate for a 7-year follow-up was in fact 9.8% with hormone therapy alone, against 5% with additional radiotherapy. In both groups, there was finally a drop of about a third in deaths from all causes.
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