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Study shows that radiation therapy can be used in some cases to treat metastatic prostate cancer

23 Mar 2021

Metastatic prostate cancer: Which men benefit from radiation therapy?

There have often been long held beliefs that once a cancer has metastasised (where the cancer has spread to another site from the original site), there is often little to be gained by treating the primary site with local anticancer therapy. More recently, strong evidence has emerged for the use of prostate radiation therapy in some carefully selected cases of newly diagnosed metastatic prostate cancer.

Data collected from just under 2000 men in the UK STAMPEDE trial was analysed and the investigators asked the question, “What type of patients with metastatic disease would benefit from prostate radiation therapy in terms of survival?”. It was important to note that both groups in the trial received standard chemotherapy doses plus lifelong hormone therapy (systemic therapy) BUT one of the groups also received radiation therapy to the prostate gland.

Those patients with three or fewer bone metastases (and where the cancer hadn’t metastasised to organs such as the liver or lung) and those with cancer in the lymph nodes outside of the pelvis were examples of favourable metastatic disease. The addition of prostate radiation therapy to this group improved their survival rate by 8% over 3 years, when compared to similar men having systemic therapy only. However, this survival benefit disappears if treating men with four or more bone metastases, the cancer has spread to organs , or there are other (non-lymph node) metastases.

Prostate radiation therapy can be considered an important part of the treatment pathway in men with low volume metastatic disease.