High-dose radiotherapy with short-term or long-term androgen deprivation in localised prostate cancer (DART01/05 GICOR): a randomised, controlled, phase 3 trial. By Zapatero et al 2015
Key sentence from the paper: “…long-term androgen deprivation plus high-dose radiotherapy is superior to short-term androgen deprivation plus high-dose radiotherapy in terms of biochemical disease-free survival and overall survival, particularly in patients with high-risk prostate cancer.”
For the full abstract, see: http://www.ncbi.nlm.nih.gov/pubmed/25702876
Commentary: It is common to start patients on ADT in advance of radiotherapy when it is administered as a primary treatment for prostate cancer. It remains controversial though as to how beneficial it is to keep patients on ADT after they completed their radiotherapy. This study looked at two groups of patients, who were treated with both ADT and radiotherapy. Both groups received four months of ADT while receiving conformal radiotherapy, but one group stayed on the ADT for the following 24 months as an “adjuvant” treatment.
There were no significant differences between the groups in terms of adverse effects from the radiotherapy. When assessed five years out, the group getting the long term ADT showed better biochemical control and overall survival than the group that got the ADT short term. The benefit of the prolonged ADT was particularly evident for patients who were considered to have high risk disease at the time of diagnosis.
The authors realize that they need a longer term follow-up data and hope to report the results for the patients in this study 10 years after their treatments. The study did not report on any negative effects of extended ADT on the quality of life of the patients in the long term ADT group.
Zapatero A, Guerrero A, Maldonado X, Alvarez A, Segundo CG, Rodriguez MA, et al. High-dose radiotherapy with short-term or long-term androgen deprivation in localised prostate cancer (DART01/05 GICOR): a randomised, controlled, phase 3 trial. Lancet Oncol. 2015;16(3):320-7.