IMRT Better than CRT Therapy for Localized Prostate Cancer

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(ChemotherapyAdvisor) – Men with localized prostate cancer treated with intensity modulated radiation therapy (IMRT) experience “a simultaneous reduction in disease recurrence and morbidity” compared with conventional conformal radiation therapy (CRT), a study presented at the 2012 Genitourinary Cancers Symposium has found.

In addition, despite the rapid growth in the number of U.S. proton facilities in the past five years, “there does not appear to be a clear benefit of proton therapy compared to IMRT,” according to Ronald C. Chen MD, MPH, of the University of North Carolina at Chapel Hill, and colleagues. This large-scale population study is the first to examine comparative outcomes of patients with prostate cancer treated with these three modalities.

The investigators analyzed data from the Surveillance, Epidemiology, and End Results (SEER)-Medicare database of more than 12,000 patients with non-metastatic prostate cancer treated with conventional CRT, IMRT, or proton therapy from 2002 to 2009. The proportion of patients diagnosed with radiation-related side effects after treatment was examined and those in each group requiring additional cancer treatments after radiation (surrogate for recurrence) determined.

Use of IMRT increased from 0.15% in 2000 to 95.9% in 2008. Men who received IMRT vs. CRT were significantly less likely to be diagnosed with GI morbidity and hip fractures—suggesting IMRT is a safer radiation technique—but more likely to be diagnosed with erectile dysfunction. Patients who received IMRT required 19% fewer additional cancer treatments. Compared with IMRT, those who received proton therapy had a higher rate of gastrointestinal problems and no significant improvement in outcomes.

“These results provide new and long-needed information to decision-makers regarding the currently available evidence on the comparative effectiveness of different RT techniques,” the investigators concluded.

The 2012 Genitourinary Cancers Symposium is sponsored by the American Society of Clinical Oncology, American Society for Radiation Oncology, and the Society of Urologic Oncology.


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