ONE-in-two men are receiving a shorter course of radiotherapy for prostate cancer thanks to research that began in the Hunter.
The results of an Australian-first study into the use of hypofractionated radiation therapy (HRT) in men with nonmetastatic prostate cancer have been published in the Journal of the American Medical Association this week.
One of the lead authors, Hunter researcher and radiation oncologist Professor Jarad Martin, said a clinical trial that began in Newcastle in 2008 had looked at whether the standard eight-week radiotherapy treatment could be halved to four weeks with a "slightly higher dose" and still achieve the same results.
"Through that we found that you get exactly the same cure rates and the same low chance of causing any side effects," Professor Martin, of GenesisCare, said. "We went on a real charm offensive in 2017 to update guidelines and present to clinicians. But the research published this week was looking at the data - through registries - about what has actually happened out in the real world. It was heartening to see that it went from nobody using the four-week schedule over a course of about three years, to about 70 per cent of people receiving the four-week schedule. So it has changed things relatively rapidly. In medicine, behaviour change can be quite challenging. They did similar research for breast cancer and it took about 15 to 18 years for that to gain traction."
But Professor Martin said the uptake of the advice, which had been popular with patients, had been "patchy".
"In Newcastle, in the public and private centres we have here, it has really been almost 100 per cent adopting the shorter version of the radiotherapy," he said. "But there are other parts of the state where it might only be a small minority of people getting the four-week version.
"So there is still work to be done in those areas."
The pandemic had also played a role in the uptake of the shorter treatment regimen.
"It was encouraged to reduce foot traffic into hospitals, and having what is often an elderly population being out and about unnecessarily," he said.
The observational study from the Australian and New Zealand Prostate Cancer Outcomes Registry followed the treatment of 8305 men diagnosed with nonmetastatic prostate cancer between January 2016 to December 2019.
Of the 6368 men identified as receiving conventional radiation therapy, the use of HRT increased from 2.1 per cent - nine of 435 patients - in the first half of 2016, to 52.7 per cent - or 539 of 1023 - in the second half of 2019.
Professor Martin said they were now looking to compress treatments even further by comparing two weeks of radiotherapy with five days.
He said reducing the treatment times, without affecting outcomes, also made the therapy more accessible and convenient for people living in rural and regional areas.
GenesisCare was also planning to open a radiotherapy centre at the new Maitland Hospital in about a month.
