Prostate Cancer: Does Timing of Radiation Therapy Affect Outcome? Interview with:
Timothy N. Showalter, MD, MPH
Associate Professor & Residency Program Director
Department of Radiation Oncology
University of Virginia School of Medicine

Medical Research: What is the background for this study? What are the main findings?

Dr. Showalter: Early radiation therapy has been shown to be an effective curative treatment for prostate cancer patietns with a rising PSA blood test after radical prostatectomy and for men with locally advanced prostate cancer who are at high risk of recurrence after prostatectomy. Despite evidence that radiation therapy is more effective when delivered early (or when the PSA is low), radiation therapy delivery is often delayed to allow more time for patients to recover urinary and sexual function. In order to provide evidence regarding whether delaying radiation therapy does reduce the risks of side effects of treatment, my colleagues and I evaluated outcomes of for a large cohort of patients who received treatment in the Emilia Romagna Region of Italy. We identified a total 0f 9,786 prostate cancer patients who received prostatectomy, including 22% of whom received post-prostatectomy radiation therapy. We found that earlier delivery of radiation therapy was not associated with increased risk of any adverse events, including gastrointestinal, urinary or sexual complications.

Medical Research: What should clinicians and patients take away from your report?

Dr. Showalter: This study provides new evidence that radiation therapy timing after prostatectomy is not a primary determinant of the risk of complications. Therefore, for patients with an indication for postoperative radiation therapy, treatment need not be delayed as long as possible in order to maximize urinary and sexual function. This is potentially reassuring information for patients with high-risk, locally advanced prostate cancer, for whom earlier radiation therapy has been shown to be more effective at achieving a prostate cancer cure than delayed radiation therapy.

Medical Research: What recommendations do you have for future research as a result of this study?

Dr. Showalter: Although this study provides direct evidence regarding the lack of effect of radiation timing on treatment-related complications, there are a number of other factors to consider in the decision-making process for prostate cancer patients faced with post-prostatectomy treatment decisions. Future research should focus on how to use new genomic tests, which provide a molecular fingerprint of a patient’s tumor, to help guide treatment decisions based upon the chance of an individual patient’s tumor progressing. This would be another important piece of evidence for patients contemplating post-prostatectomy radiation therapy.


Assessing Adverse Events of Postprostatectomy Radiation Therapy for Prostate Cancer: Evaluation of Outcomes in the Regione Emilia-Romagna, Italy
Showalter TN1, Hegarty SE2, Rabinowitz C3, Maio V4, Hyslop T5, Dicker AP6, Louis DZ3.

Int J Radiat Oncol Biol Phys. 2015 Mar 15;91(4):752-9. doi: 10.1016/j.ijrobp.2014.11.038.

[wysija_form id=”2″] Interview with: Timothy N. Showalter, MD, MPH (2015). Prostate Cancer: Does Timing of Radiation Therapy Affect Outcome?