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Posted by on Sep 27, 2022 in Prostate cancer | 0 comments

In a nutshell

This study evaluated the benefits of radiation therapy (RT) dose escalation and the addition of short-term (ST) or long-term (LT) androgen deprivation therapy (ADT) to RT in men with localized prostate cancer (PCa). The data showed that the addition of ST or LT-ADT to RT improved survival without metastasis in these patients, regardless of the RT dose.

Some background

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.

Several studies have investigated the oncological benefit of adding ADT to RT, as well as the benefit of extending the duration of ADT with RT in patients with PCa. However, there are few studies evaluating the benefit of increasing the RT dose (dose escalation) and the addition of ST or LT-ADT in men with PCa.

Methods & findings

This study analyzed 13 other studies that involved a total of 11,862 men with PCa. Patients received one of six treatments: low-dose RT alone, low-dose RT with ST-ADT, low-dose RT with LT-ADT, high-dose RT alone, high-dose RT with ST-ADT, or high-dose RT with LT-ADT. The average follow-up time was 8.8 years.

The addition of ST-ADT or LT-ADT to RT alone, regardless of RT dose, consistently improved survival without metastasis.

Escalating the RT dose up to 79.2 Gy did not improve the survival without metastasis either alone or in the presence of LT-ADT/ST-ADT.

High-dose RT plus LT-ADT was the best treatment strategy for improving survival without biochemical recurrence (BCR). BCR is a rise in the blood level of prostate-specific antigen (PSA; a protein made by cells of the prostate gland) after treatment with surgery.

The bottom line

This study concluded that escalating the RT dose alone or in the presence of ADT did not improve survival without metastasis while the addition of ST or LT-ADT to RT improved survival without metastasis in men with localized PCa.

The fine print

This study looked back in time at medical records. This study did not include data on the side effects of the treatments.

Published By :

European Urology

Date :

Apr 22, 2022

Original Title :

High-dose Radiotherapy or Androgen Deprivation Therapy (HEAT) as Treatment Intensification for Localized Prostate Cancer: An Individual Patient-data Network Meta-analysis from the MARCAP Consortium.

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