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Prostate radiation therapy proves cost-effective for early prostate cancer

Key clinical point: Adding prostate radiation therapy to standard prostate cancer treatment improved quality of life and reduced costs compared to standard androgen deprivation therapy alone.

Major finding: Over a 37-month follow-up period, adding prostate radiation therapy to androgen deprivation therapy resulted in a gain of approximately 2 months of perfect health (0.16 quality of life years) and a net cost reduction of $19,472 because fewer patients experienced cancer progression.

Study details: The data come from a multicenter, randomized clinical trial including 2,061 men with newly diagnosed metastatic prostate cancer; patients received standard of care androgen deprivation therapy with or without the addition of prostate radiation therapy.

Disclosures: The study received no outside funding. Lead author Dr. Lester-Coll had no financial conflicts to disclose. Coauthor James B. Yu, MD, disclosed personal fees from Boston Scientific and Galera Pharmaceuticals outside the submitted work.


Low-volume disease is emerging as a distinct disease entity in prostate cancer. Radiation has emerged as a potential treatment modality in this setting. In the STAMPEDE-H trial, prostate radiation was added to androgen deprivation in men with metastatic castrate-sensitive prostate cancer (mCSPC). Radiation was associated with an improvement in overall and failure-free survival in men with low volume disease. However, costs are increasingly being considered in medicine, especially when multiple treatment strategies may be reasonably considered. Lester-Coll et al. conducted a microsimulation study to model the cost effectiveness of adding radiation to a simulated cohort of men with mCSPC. For the base assumption of men aged 68 with low volume mCSPC, the model predicted an increase of 0.81 quality-adjusted life years and a savings of $30,229 per patient over a lifetime. While this is a simulation, such modeling may help with long-term feasibility of costs when planning potentially practice-changing trials.”

Mark Klein, MD


Lester-Coll NH et al. JAMA Netw Open. 2021 Jan 13. doi:10.1001/jamanetworkopen.2020.33787.