Dr. Marshall on ASCENDE-RT Trial for Prostate Cancer

David T. Marshall, MD, MS, professor, director, Medical Residency Program, Department of Radiation Oncology, Medical University of South Carolina, discusses the ASCENDE-RT trial, which compared dose-escalated external-beam radiation therapy versus low-dose-rate brachytherapy for men with unfavorable-risk localized prostate cancer.

The study compared 400 patients with 46Gy/23# dose-escalated externa-beam radiation therapy versus 46Gy/23# low-dose-rate brachytherapy. Both arms received androgen deprivation therapy for 1 year before being randomized to one of the two arms, Marshall explains.

At a 6.5-year follow-up, results showed that there was a significant benefit in prostate-specific antigen (PSA) control in patients who received brachytherapy. Marshall adds that there was an estimated 50% reduction in PSA failures in the brachytherapy arm versus the externa-beam radiation therapy arm. These results could be practice-changing for intermediate- and high-risk patients, he says.