Survival Benefit Associated With Adjuvant Androgen Deprivation Therapy Combined With Radiotherapy For High- And Low-Risk Patients With Nonmetastatic P

UroToday.com - Results of prospective randomized trials by the EORTC and RTOG showed that high risk prostate cancer patients treated with radiation therapy plus androgen deprivation exhibit a survival advantage compared with patients treated with radiation therapy alone. Nevertheless, the use of ADT in low risk patients is often indiscriminately used in low risk patients treated with radiation therapy.

In the October issue of the International Journal of Radiation Oncology - Biology, Physics, Zeliadt and colleagues from the USC Norris Cancer Center report data from 31,643 patients treated with radiotherapy or brachytherapy for localized prostate cancer. The impact of ADT in low risk patients was assessed.

After a follow-up of 8 years, patients in the low risk group failed to demonstrate a survival advantage from the use of ADT, with 8-year diseases-specific survivals of 94% without ADT and 92% with ADT. Conversely, after 8 years patients with T3 and T4 tumors showed improved survival with the use of ADT (87%) compared with 81% (p< 0.01) in high risk patients without androgen deprivation therapy. These data with a large cohort of patients support the current clinical practice guidelines suggesting that ADT should be reserved for prostate cancer patients with high risk features.

Steven B. Zeliadt, Arnold L. Potosky, David F. Penson and Ruth Etzioni

Int J Radiat Oncol Biol Phys. 2006 Oct 1;66(2):395-402
Reviewed By UroToday.com Contributing Editor Ricardo Sбnchez-Ortiz, MD

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