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January 25, 2021 – An additional dose of external radiation given directly to the tumor may benefit potential men with non-metastatic prostate cancer, without causing additional side effects. The risk of relapse within five years for these men is lower than for men who did not receive this boost, as shown by a large-scale study initiated by UMC Utrecht in collaboration with the Netherlands Cancer Institute, UZ Leuven and Radboudumc.
Radiation therapy is one of the treatment options for men with non-metastatic prostate cancer. Doctors deliver the external beam radiation to the entire prostate because cancer cells are often present in more than one area of the prostate. Only the main tumor is visible on a scan. If the cancer comes back, it often comes back where that visible tumor was. Giving an extra dose to this area appears to be very effective, as shown in the FLAME trial: a large-scale study involving 571 patients at UMC Utrecht, Netherlands Cancer Institute, UZ Leuven and Radboudumc. The results will be published Jan. 20 in the Journal of Clinical Oncology.
Less recurrence
In the study, patients received 35 sessions of radiation therapy with or without further amplification of radiation delivered to the visible tumor. The men who received the extra booster showed less recurrence in the first five years after treatment than the others. 92% of men who received the booster had low levels of PSA – an important indicator of prostate cancer – compared to 85% of men who did not. All participants were men diagnosed with intermediate or high risk tumors.
No additional side effects
“The amplification of radiation halved the percentage of men with high levels of PSA in the first 5 years after treatment: from 15 to 8%,” said radiation oncologist and head of research Linda Kerkmeijer from UMC Utrecht and Radboudumc. “The amplification of the radiation did not cause any additional side effects, which is an important finding.” Treatment is currently available at UMC Utrecht, Netherlands Cancer Institute, UZ Leuven and Radboudumc.
Prevent problems
“Our results can benefit a substantial number of men,” explained radiation oncologist Floris Pos of the Dutch Cancer Institute. “Every year in the Netherlands, we administer radiation therapy to hundreds of men who may benefit from this treatment. This could prevent a lot of problems: for our patients, cancer recurrence often means uncertainty, diagnostic tests and intense treatments like surgery or hormone therapy.
5 sessions on radiation
At the start of the FLAME trial, the standard treatment for these patients was 35 radiotherapy sessions. In recent years, that number has been reduced to 20 and to 5 for men with less aggressive tumor types. “In the meantime, we have started a follow-up study that combines these new radiation boosters with 5 sessions of radiation therapy” (see information below), explains radiation oncologist Karin Hausterman from UZ Leuven. “It looks like 5 sessions of radiation therapy could also become the new standard for this group of patients.”
For more information: www.nki.nl/
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