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Post-Surgery Radiation Boosts Prostate Cancer Results
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Page: << Prev | 1 | 2 | 3 | 4 | Next >> Post-surgical ("adjuvant") radiation has a long record of "mopping up" these stray cells and improving the survival of patients with other types of cancer. However, the jury has been out as to whether the same might be true for prostate cancer.
In its study, the largest and longest of its kind to date, Swanson's team compared 10-year outcomes in a group of 425 older prostate cancer patients who had undergone radical prostatectomy but who still showed suspicious cells in the surrounding margins. His group randomly assigned half of the men to adjuvant radiation therapy, while the other half did not receive the treatment.
Ten years later, 35.5 percent of men who received radiation had developed fatal or nonfatal metastatic disease, compared to 43 percent of those who didn't get irradiated. Overall survival rates were similar between the two groups -- 71 of 214 men who received radiation died vs. 83 of 211 men who did not get the treatment.
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Both of these results came very close to -- but did not meet -- so-called statistical significance, meaning that definite proof of treatment benefit is still lacking. However, Swanson believes "there is a compelling, although not conclusive" trend toward better survival in the irradiated group.
He also noted that about one-third of patients in the group who originally did not receive radiation eventually did receive it once they encountered a recurrence.
"People recognized that there was a benefit to radiation and said, 'Let's treat those patients,' " Swanson said. This probably caused more patients in the control group to survive than normally would have, confounding the results, he said.
Swanson said changes in other prostate cancer "markers" -- such as elevated blood levels of prostate specific antigen (PSA), a harbinger of cancer -- did meet statistical significance and were much more prevalent in men who did not undergo radiation, compared with those who did. Men who did not have radiotherapy were also 38 percent more likely to suffer disease recurrence that those who had had the adjuvant therapy, the study found.
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Copyright © 2006 ScoutNews, LLC. All rights reserved.
Last updated 11/14/2006
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SOURCES: Nov. 14, 2006, news briefing, American Medical Association, New York City, with Gregory Swanson, M.D., associate professor, radiation oncology, University of Texas Health Science Center, San Antonio; Dr. Stephen Kaplan, M.D., professor, urology, Weill Medical College of Cornell University, New York City; Leonard Marks, M.D., medical director, Urological Sciences Research Foundation, Culver City, Calif., and clinical professor, surgery/urology, UCLA School of Medicine; Nov. 15, 2006, Journal of the American Medical Association
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