Less overall radiotherapy, delivered in fewer but higher doses, is as safe as standard, lower doses for treating prostate cancer, according to new research* published in the Lancet Oncology today (Tuesday).
Data from the Cancer Research UK funded CHHiP trial – supported by the National Institute for Health Research and led by The Institute of Cancer Research (ICR) and The Royal Marsden NHS Foundation Trust – have been analysed by the ICR’s Clinical Trials and Statistics Unit.
A total of 457 men with prostate cancer were recruited to examine the safety and side-effects of higher individual doses of radiotherapy on the bowel, bladder and sexual function. All high dose results were found to be similar to standard radiotherapy.
The men either received standard radiotherapy of 74 Gy** over 37 days (2 Gy a day), 60 Gy delivered over 20 days (3 Gy a day) or 57 Gy delivered in 19 days (3 Gy per day). The next stage of the trial – which has recruited 3216 men in total – will compare outcomes in the different patient groups.
Professor David Dearnaley, lead investigator from the ICR and The Royal Marsden, said: “Earlier research suggests that prostate cancer cells may be more sensitive to higher individual doses of radiotherapy than other types of cancers. This could mean giving patients larger doses of radiotherapy per hospital visit, with fewer hospital trips and less radiotherapy needed overall. Our aim is to discover if this is the case and learn more about effective radiotherapy options for men with prostate cancer. This safety data is very pleasing and we are looking forward to the results of the next phase of the trial to see if this method ultimately offers patients better tumour control or fewer side-effects.”
Dr Emma Hall from the ICR’s Clinical Trials and Statistics Unit said: “The finding that this treatment schedule is as safe as standard treatment has allowed us to expand the trial to include men from all over the UK. This is now the largest ever academic trial in prostate cancer with 3,216 men involved.”
Around 37,000 men are diagnosed with prostate cancer every year in the UK. More than 10,000 men die from the disease annually. In the UK, radiotherapy is the most commonly used treatment to cure localised prostate cancer.
Kate Law, Cancer Research UK’s clinical trials director, said: “Radiotherapy remains a mainstay of treatment for prostate and many other types of cancer. These results highlight important ongoing research which is looking to further refine radiotherapy, and to help ensure that men with prostate cancer are getting the best treatment possible.
“All men and their families would appreciate fewer trips to the hospital to receive treatment so we look forward to seeing the full results of this research. 2011 is the Year of Radiotherapy and it’s 100 years since Marie Curie won her second Nobel Prize for her work in this area. Radiotherapy is, quite wrongly, often regarded as old-fashioned by the public. But there may be greater benefits for patients in the future as we continue to learn more about its effectiveness.”
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* Dearnaley, D., Syndikus, I., Sumo, G., Bidmead, M., Bloomfield, D., Clark, C., Gao, A., Hassan, S., Horwich, A., Huddart, R., Khoo, V., Kirkbride, P., Mayles, H., Mayles, P., Naismith, O., Parker, C., Patterson, H., Russell, M., Scrase, C., South, C., Staffurth, J., & Hall, E. (2011). Conventional versus hypofractionated high-dose intensity-modulated radiotherapy for prostate cancer: preliminary safety results from the CHHiP randomised controlled trial The Lancet Oncology DOI: 10.1016/S1470-2045(11)70293-5
** Gy refers to Gray, the unit by which radiotherapy is measured and delivered to cancer patients.