By Will Boggs, MD

NEW YORK (Reuters Health) - Less than 7 percent of men with prostate cancer who have radiation therapy experience major complications in the first 30 days, new research shows.

Radiation therapy "is quite safe for older patients, although it is associated with a small but measurable increase in short-term major complications," Dr. Shabbir M. H. Alibhai from University Health Network, Toronto, Ontario, Canada told Reuters Health.

Alibhai and colleagues compared major 30-day complications in men who had radiation therapy or radical prostatectomy (removal of the prostate) for early "organ-confined" prostate cancer.

Despite being older and having more co-existing illnesses, men who received radiation had lower complication rates in each category compared with men who had surgery, the investigators found.

Among the 7,661 men who received radiation, 9 (0.1 percent) died within 30 days. The 30-day mortality rate increased with age (from 0 percent for men younger than 60 years to 0.8 percent for men aged 80 years and older). Among the 11,010 men who had surgery, 53 (0.5 percent) died within 30 days.

Only 6.5 percent of men had at least 1 complication within 30 days of radiation, the researchers note, compared to 30.2 percent of surgery patients.

In the radiation group, complication rates peaked within 30 days and then declined promptly, for every category of complications.

"Our data confirm the belief that most prostate cancer specialists have about the relative safety of (radiation therapy) in older men," Alibhai concluded. "We recognize this is only one part of a triangle, the other points being long-term efficacy and long-term toxicity (particularly genitourinary, sexual, and gastrointestinal) that must be considered when deciding on an active treatment (i.e., radical prostatectomy or radiation therapy) for early-stage prostate cancer."

SOURCE: Cancer, January 15, 2009.

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