June 29, 2005
Trimodal approach to prostate cancer promising
NEW YORK (Reuters Health) - In patients with locally
advanced prostate cancer, a three-pronged approach to therapy
can achieve a high level of tumor control, researchers at the
University of Virginia in Charlottesville report.
The trimodal approach involves treatment with
testosterone-blocking drugs coupled with implantation of tiny
radioactive seeds in the prostate, a treatment called
brachytherapy, and external beam radiation therapy.
Trimodality therapy "is an excellent treatment for patients
with high-risk prostate cancer and offers hope in patients with
this life threatening cancer," senior investigator Dr. Dan
Theodorescu told Reuters Health.
From 3 to 5 years after initial treatment, these patients
have a high likelihood of treatment failure, as evidenced by
rising prostate-specific antigen (PSA) levels, Theodorescu and
colleagues note in the June issue of Urology.
To examine whether the trimodal approach would extend
survival, the researchers conducted a pilot study of 93
patients. Fifty-six patients were considered at high risk and
the remaining 35 were deemed to be at intermediate risk.
The patients received 8 to 9 months of hormone-blocking
drugs, followed by 2 to 3 months of external beam radiotherapy
concluding with brachytherapy.
Patients were examined at regular intervals and median
follow-up was 45 months.
At 4 years, the event-free survival rate was 85 percent for
the intermediate-risk group and 79 percent in the high-risk
group, which suggests that trimodal therapy "offers excellent
tumor control in patients with poor prognosis who often relapse
early," the team concludes.
They emphasize, however, that longer follow-up "will be
important to determine whether these results are durable over
SOURCE: Urology June 2005.