Higher dose, shorter radiotherapy for prostate cancer

21^st June 2016 - A new treatment approach for prostate cancer with higher radiotherapy doses over a shorter time works as well as current methods, but with fewer side effects according to a study.

Cancer Research UK says the NHS needs to plan for the new approach that will also save it money.

New approach to prostate cancer radiotherapy

The trial is reported in the journal Lancet Oncology and followed more than 3,200 men who were treated for prostate cancer between 2002 and 2011 at more than 70 UK centres.

The current standard radiotherapy schedule is 37 doses of 2 Gray (a measure of radiation) a day. This was compared with two alternative approaches - 19 doses of 3 Gray per day, and 20 doses of 3 Gray per day.

Five years later, the 20-dose schedule was no less effective than the current system.

The good news for men having prostate cancer treatment was that fewer but higher doses of intensity-modulated radiotherapy meant half the rate of side-effects than older NHS methods.

The trial findings have led to the new shorter course of intensity-modulated radiotherapy, which closely customises treatment to an individual patient, already being available at some UK research centres. The new system would save each man 17 hospital trips - and 150,000 fewer prostate cancer hospital visits a year for the NHS.

'Better, more convenient care'

The study was led by a team at The Institute of Cancer Research, London, and The Royal Marsden NHS Foundation Trust.

Lead investigator Professor David Dearnaley says in a statement: "Our study shows that fewer, larger doses of intensity-modulated radiotherapy work just as well as more, smaller doses for men with prostate cancer, without reducing quality of life - and would save each man the inconvenience of 17 more hospital visits."

Study co-leader Dr Emma Hall adds: "Our trial showed this modern radiotherapy is as effective when used over 20 days as over 37 days, the present standard regime. Our results also show that using state-of-the art radiotherapy methods significantly reduces the treatment side effects that matter to patients." She continued: "We already know many centres have already switched to the new regime, and we hope it will soon become the new standard of care for prostate cancer treatment on the NHS."

Professor Paul Workman, chief executive of The Institute of Cancer Research, London, says: "This is an important study which opens the door to better, more convenient care for patients while saving the NHS valuable money that can be spent on other treatments."

'Safe and effective'

The study was funded by the Department of Health and Cancer Research UK.

Reacting to the study findings in a statement, Professor Arnie Purushotham, the charity's senior clinical advisor, says: "The data allows us to recommend with confidence fewer, higher doses of radiotherapy to treat the disease.

"Shorter overall treatment ultimately means fewer trips to the hospital, and less disruption to men and their families.

"It's clear that this is safe and effective, so it's now up to the NHS to ensure all men who are suitable are offered this treatment immediately. It will save NHS resources and benefit men.

"This study is a prime example of why the NHS needs appropriate planning for new and improved treatments - including how it will invest in urgently needed radiotherapy equipment in England. Being able to quickly adapt, whether to new technology or a change to staffing levels to deliver better treatment, allows more patients to receive the benefits sooner."