Is ADT alone just as effective as a combined treatment with radiotherapy (RT)?

Final Report of the Intergroup Randomized Study of Combined Androgen-Deprivation Therapy Plus Radiotherapy Versus Androgen-Deprivation Therapy Alone in Locally Advanced Prostate Cancer. By Karmin et al 2015 

 

Key sentence from the paper: “…patients with clinically node-negative, locally advanced prostate cancer who are suitable for additional RT should be offered that option [ADT alone], an opinion shared by European and North American guidelines.

 

For the full abstract, see: http://www.ncbi.nlm.nih.gov/pubmed/25691677

 

Commentary: A big study; 1205 patients followed over a ten-year period. And it was a randomized control study that included patients with locally advanced disease. It has been an open question for some time whether patients with advanced disease really benefited from aggressive treatments, like RT, considering the toxicity associated with those treatments. The researchers found only a modest amount of increased toxicity when they added RT to ADT and that was largely short-lived. This paper adds to a recently growing body of literature supporting the use of relatively aggressive treatments with patients, who are couple of decades ago would have been considered too advanced for such treatments. It helps that the treatments (both RT and surgery) have all gotten better over the years.

 

Mason, M. D., Parulekar, W. R., Sydes, M. R. et al. Final Report of the Intergroup Randomized Study of Combined Androgen-Deprivation Therapy Plus Radiotherapy Versus Androgen-Deprivation Therapy Alone in Locally Advanced Prostate Cancer. Journal of Clinical Oncology 2015