Continuous versus intermittent androgen deprivation therapy

This study compared the efficacy of intermittent and continuous androgen deprivation therapy and their affect on quality of life.

Androgen deprivation therapy (ADT) is a hormone therapy used in the treatment of prostate cancer. The goal of this therapy is to reduce the levels of androgens (male hormones such as testosterone) in the body. Since androgens stimulate the growth and spread of prostate cells, removal of these hormones can slow or stop cancer growth for long periods. ADT is usually achieved by continuous medication therapy which inhibits androgen production. However, since ADT may induce significant adverse effects, including sexual dysfunction, an intermittent therapy course may significantly improve patient quality of life and reduce medical costs if proven effective. The current analysis reviewed all recently published data comparing continuous androgen deprivation therapy (C-ADT) to intermittent androgen deprivation therapy (I-ADT).

This analysis combined data from 8 randomized controlled trials, including a total of 4,664 advanced prostate cancer patients. Researchers found a slight increase in the risk of mortality from any cause, and cancer-specific mortality, among men receiving I-ADT versus C-ADT. However, this increased risk was not found to be statistically significant. No difference was found between intermittent and continuous therapy regarding disease progression.

Significant differences were seen in the rate of adverse effects between therapies.  Most studies concluded that I-ADT significantly reduced the rate of hot flashes and headaches compared to C-ADT. Several, but not all, of the studies reviewed also demonstrated that I-ADT led to a better overall quality of life with regards to sexual function.

This analysis found a small, yet non-significant, increased mortality risk among advanced prostate cancer patients treated with intermittent androgen deprivation therapy. However, intermittent therapy significantly reduced the rate of side effects and improved quality of life.

This analysis only reported results for advanced prostate cancer patient. Future studies should include early stage patients and stratify patients with regards to treatment indications.

Consult with your physician regarding the risks and benefits of intermittent androgen deprivation therapy.