New Discovery Boosts Radiotherapy For Prostate Cancer
The use of radiotherapy for prostate cancer can be highly effective in preventing the disease from progressing, with a key aim being to prevent metastasis, the progression of a cancer from primary to secondary, at which point it can appear in other parts of the body.
However, even when metastasis takes place, radiotherapy can still have a major impact in slowing or preventing the spread of cancer.
We offer image-guided treatment using stereotactic radiotherapy delivered in five fractions with sub-millimetre precision.. This particular form of radiotherapy is designed to aim very precise beams of intense radiation at a small area from multiple angles, helping to provide maximum dosage to disrupt the cell DNA of the cancer while minimising exposure to healthy tissue nearby.
The Benefits Of Stereotactic Radiotherapy
A key difference between the use of stereotactic radiotherapy for prostate cancer and standard beam radiotherapy is that while the latter typically involves more than 20 sessions of treatment over four to six weeks, stereotactic radiotherapy is delivered in around five treatments (fractions) over one to two weeks.
This can be very convenient for anyone travelling to our radiotherapy centre in Vienna from a distance, but what matters most is that it is also very effective.
In addition, the use of stereotactic radiotherapy for some prostate cancer patients may produce even better outcomes when combined with a specialised medicine known as a radiopharmaceutical, which delivers extra radiation to a ligand, a type of molecule that is attracted to cancer cells. They are often used to target tumours on the prostate.
This is the finding of a new piece of research that has just been presented at the annual meeting of the American Society for Radiation Oncology.
What The Research Reveals
Conducted by the University of California, Los Angeles, the Phase II LUNAR trial is the first randomised study to show that patients undergoing a combination of stereotactic radiotherapy and a radiopharmaceutical in prostate cancer with limited metastasis can live longer without disease progression than when the radiotherapy is used alone.
The particular category of patients to which the research applies is sufferers from hormone-sensitive, oligometastatic prostate cancer with between one and five metastasised lesions as detected by a scan. This means they have secondary cancer in up to five locations away from the prostate.
At present, the use of stereotactic radiotherapy for such patients has the benefit of enabling them to live longer without the level of disease progression that would require the use of androgen deprivation therapy, which can be effective as a treatment but comes with major side effects, such as reduced bone density and cardiovascular problems.
Although this use of radiotherapy brings major benefits, the cancer tends to return, which the researchers noted is due to very small-scale disease that cannot be detected by scans.
A Microscopic Threat
Lead investigator in the trial and professor of oncology at the University of California, Dr Amar Kishan, observed: “Metastasis-directed radiation therapy delays progression, but many patients still [see the cancer] recur. That tells us there must be disease present that we can’t see even with today’s advanced imaging.”
The implication is that the radiopharmaceuticals are attacking cancer cells that have not been detected in scans, reducing the capacity of undetected microscopic cancers to cause recurrences of disease.
A central finding of the trial was that for patients receiving these radiopharmaceuticals in addition to stereotactic radiotherapy, the median time that elapsed before they had to undergo hormonal therapy was 18 months, compared with seven months for those without the radiopharmaceuticals.
Dr Kishan said that while hormonal drugs remain very important in secondary cancer care, any advance in radiotherapy treatments that delays the arrival of the time when they need to be used is a “meaningful quality of life win”.
Although this benefit is clear, around 64 per cent of the patients taking radiopharmaceuticals eventually experienced disease progression, which Dr Kishan noted is a sign that further research is required into microscopic disease, its effects on cancer and the implications for treatment.
However, where one beneficial discovery has been made, others might soon follow.
How We Can Help You
If you have been diagnosed with prostate cancer and are unhappy with the level of care or form of radiotherapy you are receiving, you may find we can offer something much better in the form of stereotactic radiotherapy.
It does remain to be seen just how soon the use of radiopharmaceuticals to combat metastasised prostate cancer in the way described above becomes common practice. Further research may be carried out to verify the findings before this happens, either in the US or elsewhere, including here in Austria.
Even so, we remain committed to using the most up-to-date equipment, techniques and medical knowledge to provide the best possible treatment for our patients and achieve the most optimal outcomes.
Learn more about our Radiotherapy treatments for prostate cancer on the Amethyst Radiotherapy Austria website
