Combining radiation modalities increases

07/29/04

A new study by Mount Sinai School of Medicine researchers found that combining three therapeutic modalities significantly increased the percentage of high risk patients who are free from recurrence after five years

High-risk prostate cancer patients who undergo a combination of hormonal therapy, radioactive seed implant (also called brachytherapy) and external beam radiation therapy are shown to have an increased chance of cancer cure, according to a new study by researchers at Mount Sinai School of Medicine published in the August 1, 2004, issue of the International Journal of Radiation Oncology*Biology*Physics.

Historically, high-risk prostate cancer has been a therapeutic challenge for physicians, despite their efforts to cure patients by aggressively treating them with either surgery, brachytherapy or external beam radiation.

Previous studies have shown the 5-year freedom from recurrence rates for high-risk patients treated with just one of these treatments to be between 0 and 50 percent, with up to half of these failures occurring where the original tumor was found.

To see if combining therapies would decrease recurrence rates for men with high-risk prostate cancer, 132 patients with high Gleason scores, high prostate-specific antigen (PSA) scores or who were at an advanced clinical stage of prostate cancer were studied.

A three-pronged approach that included brachytherapy, external beam radiation therapy and hormonal therapy produced an 86 percent rate of freedom from recurrence after five years. In addition, 47 of the original 132 patients in the study had a prostate biopsy performed two years after the end of treatment and 100 percent of them showed no evidence of the cancer recurring.

"This is a very exciting study because it shows that this new approach of combining brachytherapy, external beam irradiation and hormonal therapy to cure prostate cancer can be very effective for men with aggressive forms of the disease," said Richard G. Stock, M.D., lead author of the study and Chairman of the Department of Radiation Oncology at Mount Sinai School of Medicine. "The data also supports the theory that enhanced local control can improve overall disease control."

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