An extra radiation boost for prostate cancer patients reduces the chance that the disease will return within five years. This is evident from the FLAME trial, a large study by the UMC Utrecht, the Antoni van Leeuwenhoek, UZ Leuven and the Radboudumc, which was recently published in the scientific journal Journal of Clinical Oncology.
Prostate cancer is the most common cancer in men in the Netherlands. Every year, more than twelve thousand men are told that they have prostate cancer. In more than half the cancer cells have not yet spread, according to figures from the Comprehensive Cancer Center Netherlands. There are various treatment options, including radiation, hormone therapy and surgical removal of the prostate.
The research is good news for men with non-metastatic prostate cancer who receive radiation therapy for it. Although the scan often only shows the main tumor, doctors still irradiate the entire prostate, because the cancer cells are usually located in several places.
“When the disease returns, it is regularly exactly where the visible tumor was,” says radiation oncologist and principal investigator Linda Kerkmeijer of the UMC Utrecht and Radboudumc. “That is why we decided to investigate whether an extra radiation boost would have an effect on that spot.”
No additional side effects
In the study, almost six hundred patients received 35 radiation treatments. Half received an extra radiation boost to the tumor and the other half did not. In the first group, fewer participants had cancer recurrence in the first five years after treatment than in the other group.
“Recurrent prostate cancer brings uncertainty and heavy follow-up treatments, such as surgery or hormone therapy. With this new treatment, the chance of this decreases considerably. “
Floris Pos, radiotherapeut
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Kerkmeijer: “The extra dose of radiation halves the proportion of men whose PSA value – an important indicator for prostate cancer – rises again in the first five years after treatment; it fell from 15 to 8 percent. Moreover, the radiation boost did not cause any additional side effects. . “
Treatment can save a lot of suffering
The treatment is now available at UMC Utrecht, Antoni van Leeuwenhoek and Radboudumc. According to radiotherapist Floris Pos of the Antoni van Leeuwenhoek, a substantial number of men benefit from the new treatment. “Every year we irradiate hundreds of men in the Netherlands who are eligible for this treatment.”
It can save patients a lot of suffering, according to Pos. “Recurrent prostate cancer brings uncertainty, new investigations and heavy follow-up treatments, such as surgery or hormone therapy. With this new treatment the risk of this is significantly reduced.”
Only irradiate five times
When the FLAME trial started, the standard treatment for this group of patients was irradiation 35 times. In recent years, this has been adjusted to twenty times. For men with a less aggressive form it is even about five treatments.
Kerkmeijer: “We have already started a follow-up study. We want to see whether the new boost treatment is also effective when we combine it with only five irradiation. The treatment of prostate cancer by means of irradiation may therefore be even less burdensome in the future.”
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