Addition of radiotherapy to endocrine therapy has little negative long-term effect on QOL among men with prostate cancer, study shows

The substantial benefits of adding radiotherapy to endocrine treatment for locally advanced prostate cancer outweigh significant increases in some treatment-related symptoms, research indicates, particularly since the symptoms often associated with radiotherapy appear to have little additional effect on quality of life (QOL) after 4 years. Researchers analyzed self-reported patient data from a previous open-label Phase III trial of 872 men with locally advanced prostate cancer who had...

The substantial benefits of adding radiotherapy to endocrine treatment for locally advanced prostate cancer outweigh significant increases in some treatment-related symptoms, research indicates, particularly since the symptoms often associated with radiotherapy appear to have little additional effect on quality of life (QOL) after 4 years.

Researchers analyzed self-reported patient data from a previous open-label Phase III trial of 872 men with locally advanced prostate cancer who had received 3 months of total androgen blockade followed by either continuous endocrine treatment or the same endocrine treatment plus radiotherapy 3 months after study entry.

Disease-specific urinary, bowel, and sexual function symptoms, as well as QOL, were the primary outcome measures for this analysis.

Significantly more patients in the radiation group reported more moderate to severe urinary bother than in the endocrine-only group. Reports of bowel symptoms were also significantly higher in the radiation group.

Large proportions of both groups reported erectile dysfunction, although the condition was reported by significantly more patients in the combined group than in the endocrine-only group (85% vs 72%; P=.0002).

At 4 years, however, the only QOL measure that differed significantly between the groups was social function, which was decreased among the subjects receiving radiotherapy.

"The addition of radiotherapy to endocrine treatment led to significant worsening of some symptoms. Clinically significant differences in radiotherapy-induced symptoms between treatment groups were expected, but they were also small," the authors concluded. "Relative to the benefit on overall survival, death from prostate cancer, and delayed prostate-specific antigen relapse, the increase of symptoms with the addition of radiotherapy seems small and has little effect on quality of life 4 years after treatment." (Fransson P, et al. Lancet Oncol 2009;10:370-380.)