Longer Androgen Deprivation Beneficial in Prostate Cancer
All outcomes but survival improved; survival improved in aggressive cancers
THURSDAY, April 17 (HealthDay News) -- Long-term androgen-deprivation therapy significantly improves many outcomes in locally advanced prostate cancer, except survival, although survival is also improved in patients with more aggressive cancers, according to a report published online April 14 in the Journal of Clinical Oncology.
Eric M. Horwitz, M.D., from Fox Chase Cancer Center in Philadelphia, and colleagues treated 1,554 prostate cancer patients with goserelin and flutamide before and during radiation therapy for four months, then randomly assigned patients to no further androgen-deprivation therapy or 24 additional months of goserelin. Both groups continued to receive radiation.
At 10 years, the researchers found that patients receiving long-term androgen-deprivation therapy had significantly better disease-free survival, disease-specific survival, local progression, distant metastasis and biochemical failure, but not overall survival. However, in a subgroup of prostate cancers with a Gleason score of 8 to 10, there was a significant improvement in survival as well as all other endpoints.
"Long-term androgen-deprivation therapy as delivered in this study for the treatment of locally advanced prostate cancer is superior to short-term androgen-deprivation therapy for all end points except survival," Horwitz and colleagues conclude.