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SAN FRANCISCO, CA USA (UroToday.com) - Dr. Fosså presented updated results from the Scandinavian Prostate Cancer Group 7 (SPCG 7) randomized controlled trial of lifelong hormone treatment alone or combined with radiotherapy.

When the results of this trial were first reported at 7.6 years of follow-up, men with locally advanced or advanced (based on histological criteria) prostate cancer treated with 3 months of total androgen blockade followed by radiotherapy and continuous anti-androgen therapy were associated with a 12% reduction in prostate cancer specific mortality compared to hormone treatment alone. The authors presented updated 10- and 15-year survival results after a median observation period of 10. 7 years.

gucancerssympalt thumbPatients included in the trial were < 75 years old, had a PSA < 70, T3 (80% of patients) or T1/2 grade 2/3 disease, “good” performance status, and cN0 disease (all patients with PSA > 10 underwent PLND). Patients randomized to combination therapy received 70-75Gy pelvic EBRT and lifelong anti-androgen therapy. Prostate cancer specific death occurred in 26.9% and 10.3% of patients treated with anti-androgen monotherapy and combination therapy, respectively (p < 0.001) (death due to any cause: 47.8% and 36.9%, respectively). Ten-year prostate cancer-specific mortality was 8.3% for patients treated with combined therapy compared to 18.9% for monotherapy. Fifteen-year prostate cancer-specific mortality was also improved for patients treated with combination therapy (12.4% vs. 30.7%). Similar results favoring combined therapy were reported for overall mortality at 10 (26.4% vs 35.3%) and 15 (43.4% vs 56.7%) years.

At 4 years of follow-up, there was no impact of combination treatment on global quality of life. A post-randomization prostate biopsy study revealed recurrent or persistent disease in 66% vs 12% of patients treated with anti-androgen therapy alone or combined therapy, respectively. Dr. Fosså reported that these data are comparable to large recently published series of radical prostatectomy, however a head-to-head comparison of RP and combined therapy should be defined in randomized trials. Among men with locally advanced or high-risk prostate cancer, the addition of radiotherapy to androgen blockade more than halves prostate cancer-specific and overall mortality. The author’s recommend combined therapy be considered a standard curative treatment option.

Highlights of a presentation by Sophie D. Fosså, MD, PhD at the 2014 Genitourinary Cancers Symposium - January 30 - February 1, 2014 - San Francisco Marriott Marquis - San Francisco, California USA

The Norwegian Radium Hospital, Oslo, Norway 

Written by Jeffrey J. Tomaszewski, MD, medical writer for UroToday.com

Click HERE to view the presenter's slides from this session

View Full 2014 GU Cancers Symposium Coverage 

 

 

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