Treating an aggressive disease is always challenging but improving the way therapies are applied can benefit patients by giving them a better outcome.
In a new study published by European Urology, UCLA researchers and colleagues from ten other institutions examined the protocol for treating aggressive prostate cancer. With aggressive forms of this disease, it is often unclear if radiation therapy should be applied to the prostate alone or to the whole pelvis. The reason a low-dose of radiation may be applied to the whole pelvis is that pelvic lymph nodes may have microscopic cancer cells within them.
Previous tests have proven that a high dose of radiation is effective in treating prostate cancer. This new study set out to learn if treating men with a high dose of radiation for their prostate, along with a lower dose of radiation for their pelvic lymph node would improve their outcomes.
“We undertook this study because several randomized trials have failed to show any benefit to prophylactically treating the whole pelvis region with radiation along with treating the prostate,” said Dr. Amar Kishan, a member of the UCLA Jonsson Comprehensive Cancer Center. “However, these trials have been limited by delivering substandard doses of radiation to the prostate. This raises the question of whether treating the pelvic nodes in conjunction with high-dose radiation to the prostate would be helpful.”
The study assessed 1,170 patients who were treated between 2000 and 2013 for an aggressive form of prostate cancer. Using a statistical model, the UCLA researchers compared the outcomes for men who were treated with radiation for their prostate alone versus men who received similar high-dose treatment for their prostate in conjunction with radiation for their whole pelvis.
The study results showed that patient outcomes improved when they received a high dose of radiation therapy for their prostate along with radiation for their whole pelvis region. The UCLA researchers however also noted that a randomized trial is required to further prove their conclusions.
The team that contributed to this study include:
UCLA: Kiri Sandler (first author), Ryan Cook, David Jeffrey Demanes, John Hegde, Sun Mi Yoo, Michael Steinberg, Amar Kishan, Nicholas Nickols, William Aronson (and with Veteran Affairs Greater Los Angeles Healthcare System), Robert Reiter, Jonathan Said, Patrick Kupelian, Christopher King; Cleveland Clinic: Jay Ciezki, Eric Klein, Andrew Stephenson; Dana-Farber Cancer Institute: Mark Pomerantz, Paul Nguyen, Grace Shaw, Anthony D’Amico; Fox Chase Cancer Center: Talha Shaikh, Eric Horwitz; The Johns Hopkins University: Ashley Ross, Phuoc Tran, Ridwan Alam, Chandana Reddy, Daniel Song, Jeffrey Tosoian, Stephen Greco, Curtiland Deville Jr., Todd McNutt, Theodore DeWeese; Mount Sinai: Richard Stock; Oakland University: Daniel Krauss; Oslo University Hospital: Trude Wedde, Wolfgang Lilleby; University of Michigan: Daniel Spratt, Eyad Abu-Isa; Veteran Affairs Greater Los Angeles Healthcare System: Ahmad Sadeghi; and Wheeling Jesuit University: Gregory Merrick, Ryan Fiano.