Fewer Complications With IMRT for Prostate Cancer

Fewer gastro morbidities, hip fractures, but more erectile dysfunction versus conformal radiation

TUESDAY, April 17 (HealthDay News) -- For patients with nonmetastatic prostate cancer, treatment with intensity-modulated radiation therapy (IMRT) is associated with fewer complications than proton therapy or conformal radiation therapy, according to a study published in the April 18 issue of the Journal of the American Medical Association, a theme issue on comparative effectiveness research.

To investigate the morbidity and disease control of IMRT, proton therapy, and conformal radiation therapy, Nathan C. Sheets, M.D., of the University of North Carolina at Chapel Hill, and colleagues analyzed Surveillance, Epidemiology, and End Results-Medicare-linked data for patients with nonmetastatic prostate cancer from 2000 to 2009.

The researchers found that, compared with conformal radiation therapy, use of IMRT increased from 0.15 percent in 2000 to 95.9 percent in 2008. Men who received IMRT were less likely to have gastrointestinal morbidities (absolute risk, 13.4 versus 14.7 per 100 person-years; relative risk [RR], 0.91) and hip fractures (absolute risk, 0.8 versus 1.0 per 100 person-years; RR, 0.78) compared with men receiving conformal radiation therapy. However, men receiving IMRT were more likely to be diagnosed with erectile dysfunction (absolute risk, 5.9 versus 5.3 per 100 person-years; RR, 1.12). Patients treated with IMRT had a lower rate of gastrointestinal morbidity (absolute risk, 12.2 versus 17.8 per 100 person-years; RR, 0.66) compared to patients receiving proton therapy. Rates of other morbidities were similar for IMRT and proton therapy.

"This population-based study suggests that IMRT may be associated with improved disease control without compromising morbidity compared with conformal radiation therapy, although proton therapy does not appear to provide additional benefit," the authors write.

Two authors disclosed financial ties to the pharmaceutical industry.

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