Karmanos, WSU SOM present long-term results of fast neutron radiotherapy in localized prostate cancer

Oct 30 2010

Scientists from the Barbara Ann Karmanos Cancer Institute and Wayne State University School of Medicine (WSU SOM) in Detroit will present the world's largest study that shows the long-term results of fast neutron radiotherapy (FNRT) in the treatment of localized prostate cancer. The findings will be formally announced Tuesday, Nov. 2, at the American Society of Therapeutic Radiology and Oncology (ASTRO) Annual Meeting.

Tushar Kumar, M.D., a former radiation oncology resident at Karmanos and WSU SOM, was lead author of the study, titled, "Long Term Results of the Wayne State University Fast Neutron Radiotherapy Experience in the Treatment of Localized Prostate Cancer." The research will be part of an oral presentation during the prostate cancer session at ASTRO. Dr. Kumar is now a staff radiation oncologist at Southern Massachusetts Hospital's South Coast Center for Cancer Care.

Fellow authors from Karmanos and WSU SOM include David Elliott and Brandon Mancini, both fourth-year medical students; Sue Bolton, research assistant; Michael Cher, chairman of the Department of Urology; Ulka Vaishampayan, M.D., team leader of the Genitourinary Oncology Multidisciplinary Team; Jordan Maier, medical director of the Karmanos Cancer Center in Farmington Hills, Mich., and Andre Konski, M.D., MBA, MA FACR, chairman and clinical service chief of the Department of Radiation Oncology.

Researchers analyzed the results of multiple clinical trials that were held at Karmanos and WSU SOM from 1992 to 2007. During that time, Karmanos treated 1,006 patients with a combination of photon radiotherapy and FNRT – the largest number of patients in the world.

Dr. Kumar has updated the clinical results, which had been previously published. The purpose of the current study was to report on the long-term outcome and toxicity levels of patients treated with fast neutron radiotherapy. Of the more than 1,000 patients who went through the trials, almost 60 percent were alive at the time of analysis.

Dr. Kumar notes that FNRT technology isn't new – it's been used since 1938. It gained popularity in the 1980s, when 10 centers were delivering this type of therapy, but has since dropped off.

"Fast Neutron Therapy is very powerful and radiobiologically very advantageous to the patient. Without the use of this current technology, there were substantial side-effects in earlier world-wide trials," Dr. Kumar said. "It's unique technology and through systematic clinical trials and technological advances at Karmanos, we found an appropriate and safe way to use it with excellent clinical results."

In the study, researchers looked at the effects of FNRT in the treatment of low, intermediate and high-risk prostate cancer cases. Overall survival and biochemical progression-free survival were analyzed within risk groups; in groups where post-radiotherapy hormones were used; and by race. Researchers also scored the levels of genitourinary (GI) and gastrointestinal (GU) toxicity in patients.

What researchers found was that treatment of prostate cancer patients with FNRT resulted in excellent long-term overall survival and biochemical progression free survival for all risk groups, with low rates of late GI and GU toxicities. The use of hormone therapy improved overall survival in low and intermediate risk groups, though not in high-risk groups.

"Our research found that intermediate or high-risk prostate cancer may have a better benefit from FNRT," said Dr. Kumar. "Many cancers can be treated with FNRT. You can use it for sarcomas, melanomas, glioblastomas (brain cancers), resistant lung cancers and head and neck cancers. We are seeing excellent outcomes with FNRT and that's the goal of my research – to show excellent outcomes."