Effect of complementary alternative medical (CAM) therapy on tumor response, control and recurrence in prostate cancer patients (PCpts) treated with radiation therapy (RT)

Abstract

15585 Background. CAM therapy in pts receiving RT has been questioned due to possible interference with oxidative mechanisms aimed at killing tumor cells. We addressed this controversy by analyzing tumor response, control and recurrence in PCpts treated with RT + CAM. Methods. The population consisted of 125 RT-treated PCpts with localized tumors: CAM cohort (n=69; median age=62.5 yrs; range=46–81); nonCAM cohort (n=56; median age=61.0 yrs; range=48–80). For the CAM cohort, 41%, 42%, 9% and 7% had T1c, T2a, T2b and T2c tumors respectively with 1 T3b tumor; for the nonCAM cohort, 39%, 38%, 14% and 7% had T1c, T2a, T2b and T2c tumors respectively with 1 T3a tumor. RT consisted of external beam therapy (4500–5000 cGy) in conjunction with high dose rate brachytherapy (600- 650 cGy/fraction x 2–3 fractions) administered over 6–8 weeks; this occurred for 65/69 CAM and 52/56 nonCAM pts. The remaining pts received either HDR monotherapy, tomotherapy, or IMRT + tomotherapy. In addition, 5/69 CAM and 2/56 nonCAM pts received hormonal therapy. CAM regimens included at least one antioxidant (range=1–7) including Green Tea Extract; Melatonin; and high-potency multivitamins. All pts were monitored ≥ 24 months post radiation therapy. Results. In the CAM cohort, median pretreatment PSA was 5.95ng; nadir PSA was 0.08ng; and last PSA was 0.18ng with median followup of 28.96 (range=24–46) months; 3 biochemical failures were seen at 6, 10 and 12 months. In the nonCAM cohort, median pretreatment PSA was 6.4ng; nadir PSA was 0.06ng; and last PSA was 0.166ng with median followup of 28.26 (range=24–43) months; 2 biochemical failures at 13 and 28 months with 1 death at 37 months were seen. Conclusion. Concomitant CAM treatment does not effect RT-mediated tumor response, control or recurrence rates in PCpts with localized disease. Neither the magnitude of the response or its durability for at least 2 years are negatively affected by CAM-based antioxidant supplements designed to improve patient tolerance and quality of life. Investigations in well-defined populations receiving consistent CAM regimens offer the opportunity to elucidate positive benefits for patient management. No significant financial relationships to disclose.

Postradiation Fractures after Combined Modality Treatment in Extremity Soft Tissue Sarcomas

“…erefore, many oncologists avoid administration during active treatment, reserving use until therapy is completed [71]. However, studies have not shown detrimental effects with concomitant administration of radiation with antioxidants [71][72][73]. ere appears to be less concern about use of amifostine during radiation treatment, with several studies showing that concurrent use did not affect treatment outcome [71,[74][75][76].…”

Do Antioxidants Interfere With Radiation Therapy for Cancer?

“…40 An updated version of this study was presented at the American Society of Clinical Oncology (ASCO) meeting in Chicago, June 2007. 41 In the 2006 study, 13 patients received naturopathic therapy including antioxidants (CAM group) and 9 individuals did not (non-CAM group). External beam radiation therapy of up to 72 Gy was given to all patients on a conventional 8-week treatment regimen.…”