Chemo-radiation before prostate removal may prevent cancer recurrence

OHSU Knight Cancer Institute findings prompt Phase II clinical trial for high-risk prostate cancer patients

PORTLAND, Ore. — Researchers in the Oregon Health & Science University Knight Cancer Institute and the Portland Veterans Affairs Medical Center have found a combination of radiation therapy and chemotherapy given before prostate removal is safe and may have the potential to reduce cancer recurrence and improve patient survival.

Their findings were presented this week at the 51st annual meeting of the American Society of Therapeutic Radiology and Oncology in Chicago.

"In men with aggressive prostate cancer, standard therapies such as radiation or surgery often fail to eliminate the cancer completely at the site of treatment. When these cancers recur, they are often fatal," said Mark Garzotto, M.D., principal investigator and Associate Professor of Urology and Radiation Medicine in the OHSU Knight Cancer Institute; and Chief of Urologic Oncology in the Portland Veterans Affairs Medical Center.

Previous clinical trials examining the effect of either hormonal therapy or chemotherapy prior to surgery have shown little if any benefit over prostate removal alone. "Novel approaches are needed if we are to make advances in this disease," added Dr. Garzotto.

The use of multimodality therapy — combined radiation, chemotherapy and surgery — has resulted in improved outcomes in a number of cancers, but has not yet been studied in prostate cancer.

This study looked at whether radiation therapy and chemotherapy (docetaxel) administered before surgery is possible, safe, and, ultimately, capable of preventing cancer recurrences. To answer these questions, Garzotto and colleagues developed a treatment regimen in which radiation and docetaxel were administered together before prostatectomy.

Twelve eligible participants were enrolled in the study between April 2006 and March 2008. The men were given intensity-modulated radiation therapy and increasing doses of docetaxel for five consecutive weeks, which was followed by surgical removal of the prostate gland.