Co nowego w leczeniu napromienianiem raka stercza oraz raka pęcherza moczowego na podstawie doniesień z Konferencji Amerykańskiego Towarzystwa Radioterapii Onkologicznej (ASTRO), San Francisco 2014?

Abstract

During the ASTRO 56 conference, which was held in San Francisco in 2014, majority of the scientific sessions on prostate cancer were devoted to the combined treatment (radiation and hormone therapy). Modern radiotherapy in the last decade contributed significantly to improved treatment results of prostate cancer. However, especially in the group of more advanced prostate cancer, we can expect further improvement in treatment results. This combined therapy should improve treatment results because of the reduction in the dose delivered to the rectum and the bladder, the most important organs at risk for radiotherapy of prostate cancer.Zapatero and coworkers from Spain presented the results of randomized phase III clinical trial (DART 01/05). In the study, they compared the results of treatment of high risk and intermediate risk of progression in prostate cancer patients with radiotherapy combined with hormonal therapy. Into the study were included 364 patients with prostate cancer who were randomized between 2005 and 2010 to the arm where the hormone therapy was used only for 4 months before the start of radiation therapy (neoadjuvant) and to the second arm where the hormone was continued for 24 months after the complition of radiotherapy. Results suggested that the biggest benefit from long-term use of hormone therapy was observed in the group of patients at high risk of progression (cT3 or PSA> 20 ng/mL or Gleason> 7) in prostate cancer.

The second very important scientific report presented at the plenary session during the conference ASTRO 2014 was related to the phase III randomized trial RTOG 0126, which assessed the results treatment in patients with intermediate risk of progression when using high dose (79.2 Gy) or standard dose of radiation (70.2 Gy). Authors of the study did not show a significant gain in overall survival or specific survival for prostate cancer from the use of higher dose in the group of intermediate risk prostate cancer. Dose escalation resulted in statistical improvement in biochemical relapse-free survival.