Evaluating the benefits of adding androgen deprivation therapy to radiation therapy and extending its duration in men with localized prostate cancer.

This study evaluated the benefits of adding androgen deprivation therapy (ADT) to radiation therapy (RT) and the benefit of extending the duration of ADT in men with localized prostate cancer (PCa). The data showed that the addition of ADT to RT and extending the duration of ADT administered after RT significantly improved the survival without metastasis in men with localized PCa.

Localized prostate cancer (PCa) is a form of cancer that has not spread beyond the prostate gland. PCa can be treated by surgery, radiotherapy (RT), or hormone therapy such as androgen deprivation therapy (ADT). ADT reduces the production of androgens (male sex hormones such as testosterone). Reducing these androgens prevents cancer cell growth. Quite often, ADT is administered to reduce tumor size prior to other treatments such as RT or surgery. This is called neoadjuvant ADT. When ADT is administered during or after RT it is called adjuvant ADT.

Several studies have investigated the oncological benefit of adding ADT to RT and extending the duration of ADT with RT in patients with PCa. These studies differed in RT dose, the type of ADT used, the duration of ADT, and the timing of ADT with RT. It is important to evaluate the benefit of adding ADT to RT and extending the duration of ADT in men with localized PCa.

This study analyzed 12 studies and involved 10,853 men with localized PCa. The average follow-up time was 11.4 years.

The addition of ADT to RT significantly improved the survival without metastasis by 17% compared to RT alone. Adding ADT to RT also improved overall survival, cancer spread, and cancer return risk.

Extending the total adjuvant ADT duration from 18 to 36 months significantly improved the survival without metastasis by 16% compared to extending the total ADT adjuvant duration from 4 to 6 months. Longer adjuvant ATD also improved overall survival, the risk of cancer spreading away from the prostate, and cancer return. 

Extending the total neoadjuvant ADT duration from 6 to 9 months did not significantly improve the survival without metastasis compared to extending the total ADT adjuvant duration from 3 to 4 months.

This study concluded that the addition of ADT to RT and extending the duration of ADT administered after RT significantly improved the survival without metastasis in men with localized PCa.

This study looked back in time at medical records. The studies took place over 23 years, during which the definition and grading of localized PCa have changed.