Radiotherapy for prostate cancer on the NHS could change after a new system that delivers higher-beam doses over a shorter period was found to work as well as existing treatment.



Researchers leading a 14-year trial said the altered therapy plan could save the NHS tens of millions of pounds per year and did not appear to increase the risk of long-term side effects.

The study involving more than 3,200 patients compared a 20-session course of “intensity-modulated radiation therapy” (IMRT) – which closely customises treatment to an individual patient – with the current standard 37 sessions.

For the shorter programme, the daily dose of radiation was increased from two to three Grays. A Gray is a measurement of the amount of radiation energy absorbed by one kilogram of body tissue.

After five years, the new schedule was shown to match the standard protocol in terms of both effectiveness and quality of life.

Lead investigator Prof David Dearnaley, from the Institute of Cancer Research in London, said: “Our study shows that fewer, larger doses of intensity-modulated radiotherapy work just as well as more, smaller doses for men with prostate cancer, without reducing quality of life – and would save each man the inconvenience of 17 more hospital visits.

“If the new regime is incorporated into routine clinical practice, it will save the NHS tens of millions of pounds per year as well as freeing up space for other patients to have radiotherapy more quickly.”

Across the country, more than 150,000 hospital visits per year could be saved if the system was adopted by the NHS, it is claimed.

The trial has already introduced IMRT for prostate cancer at dozens of research centres in the UK.

Intensity-modulated radiotherapy allows different doses of radiation to be delivered to different parts of the treatment area. This helps to minimise side effects when treating cancers that are close to important organs or structures.

Older “conformal” radiotherapy also shapes the radiation beams to suit the patient’s body, but with much less precision.

The new results, published in The Lancet Oncology journal, showed that fewer, higher doses of IMRT more than halved the rate of side effects typically seen with conformal radiotherapy.

One of the most serious hazards associated with radiotherapy for prostate cancer is its apparent ability to trigger bladder cancer several years later. The treatment increases the risk of developing bladder cancer by 40%.

The radiotherapy trial was funded by Cancer Research UK.

Study co-leader Dr Emma Hall, deputy director of the Clinical Trials and Statistics Unit at the Institute of Cancer Research, said: “We already know many centres have already switched to the new regime, and we hope it will soon become the new standard of care for prostate cancer treatment on the NHS.”