Two landmark clinical trials have shown that radiation plus hormone therapy produces a large and significant improvement in survival in younger men relative to hormone therapy alone, but until now there has been no comparable research on treatment for older men with advanced prostate cancer.
Addressing this question for the first time, Penn's research team compared the combination of radiation plus hormone therapy versus hormone therapy alone among 31, 541 men with prostate cancer ranging in age from 65 years to 85 years.
- Among men age 65 to 75 years old, radiation plus hormone therapy was associated with a reduction in prostate cancer deaths of 57 percent relative to hormone therapy alone (from 9.8 percent to 4.4 percent of patients at 7 years follow up).
- Similarly, among men age 76 to 85 years old, radiation plus hormone therapy was associated with a reduction in prostate cancer deaths of 49 percent relative to hormone therapy alone (from 9.8 percent to 5.0 percent of patients at 7 years follow-up).
- In both groups, radiation plus hormone therapy was also associated with about one-third fewer deaths from any cause.
- Importantly, the clinical trials have shown that the side effects of radiation plus hormone therapy are very acceptable relative to hormone therapy alone.
In addition to offering new evidence for older men, Bekelman's research also demonstrates that the prior clinical trial findings for younger men apply in the "real-world" of routine clinical practice. Only three percent of cancer patients participate in clinical trials; thus, confirming that treatments work in real-world care is a crucial aspect of translating medical evidence to clinical practice.
Bekelman's study is an example of patient-centered cancer comparative effectiveness research, which provides reliable, useful information to help individual patients make informed cancer care decisions and improve cancer care outcomes.
The Penn-led study examined radiation treatment and hormone therapy in the Surveillance Epidemiology and End Results (SEER) Medicare database. SEER collects data from population-based cancer registries that cover 26 percent of the U.S. population and Medicare, which covers 97 percent of the U.S. population 65 years of age or older. Patients received treatments not by random assignment but as part of their normal clinical care. Bekelman's team utilized specialized analysis techniques to mimic randomized clinical trials in data from routine care and to identify which treatments are best for men of different age groups and cancer severity.
Penn Study: Radiation Plus Hormone Therapy Prolongs Survival for Older Men with Prostate Cancer
Prolonged survival for older men with prostate cancer - CareAcross
Clinical outcome: 1/3 fewer deaths
Penn's research team compared the combination of radiation plus hormone therapy versus hormone therapy alone among 31,541 men with prostate cancer ranging in age from 65 years to 85 years.- Among men aged 65 to 75 years old, radiation plus hormone treatment was associated with a reduction in prostate cancer deaths of 57% relative to hormone treatment alone.
- Similarly, among men aged 76 to 85 years old, radiation plus hormone treatment was associated with a reduction in prostate cancer deaths of 49% relative to hormone treatment alone.
Patients received treatments not by random assignment but as part of their normal clinical care. Bekelman's team utilized specialized analysis techniques to mimic randomized clinical trials in data from routine care and to identify which treatments are best for men of different age groups and cancer severity.
Related links:
- How to handle a relapse after treatment for prostate cancer - Harvard Prostate Knowledge - Harvard Health Publications
- Prostate Cancer Survivors - Treatment Choices
- Patient's Guide to Prostate Cancer: Treatments | Patient Education | UCSF Medical Center
- Prostate Cancer Treatment (PDQ®) - National Cancer Institute
- Prostate Cancer - In-Depth Report - NY Times Health
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