How long should hormonal therapy continue in patients who have received postprostatectomy radiotherapy?

This study examined how long hormonal therapy should continue in patients who have received radiotherapy after prostate removal surgery (prostatectomy). This study concluded that patients with a higher number of risk risk factors should receive HT for a longer period of time. 

Radical prostatectomy (RP) is surgery to remove the entire prostate gland and surrounding lymph nodes. This is a treatment for men with localized (has not spread) prostate cancer. Radiotherapy and hormonal therapy (HT) are other treatment options for prostate cancer. HT is intended to reduce the production of androgens (male sex hormones such as testosterone), or inhibit their effect on cancer cell growth. Many physicians recommend the use of radiation therapy following RP. This is meant to destroy any remaining cancer cells.

It is not known how long HT should be given to patients who have received radiotherapy after RP. 

This study included 1264 patients who received radiotherapy after RP. HT was given to 363 patients (29%), based on their doctors' decision. The average length of HT treatment was 9 months. 

After an average of 93 months after surgery, recurrence was seen in 182 patients. 92% of patients had not experienced recurrence 8 years after treatment. The risk of recurrence was lower in patients who had HT over a longer period of time. 

Three risk factors for recurrence were recorded. These included increased PSA (a marker of prostate cancer), a Gleason score (a grading system to describe aggressiveness of the tumor) of 8 or more, and what stage of cancer patients were diagnosed with. Patients with more risk factors received HT over a longer period of time. For patients with 2 or more risk factors, HT was beneficial when it was given for up to 36 months. In patients with one risk factor, HT had a slight benefit when given for less than 12 months. For patients without any risk factors, there was no benefit to receiving HT.

This study concluded that patients with a higher number of risk factors should receive HT for a longer period of time. 

This study looked at patient medical records. Clinical trials are required to see if these results can be repeated. 

If you have concerns about prostate cancer treatment, please consult with your doctor.