When is it beneficial to add chemotherapy to ADT plus radiotherapy?

While some of the papers that we have recently reviewed support the early use of chemotherapy in conjunction with ADT, this paper found no benefit to giving chemotherapy as adjuvant treatment to patients, who are already treated with long-term androgen suppression plus radiotherapy. This trial, however, was designed back in 1999 and the treatments have changed greatly since then. For example, the chemo protocol back then was a combination of paclitaxel, estramustine and etopodide. In the newer studies that showed a benefit to ADT plus chemotherapy, the chemo agent was docetaxel.


Rosenthal SA, Hunt D, Sartor AO, Pienta KJ, Gomella L, Grignon D, Rajan R, Kerlin KJ, Jones CU, Dobelbower M, Shipley WU, Zeitzer K, Hamstra DA, Donavanik V, Rotman M, Hartford AC, Michalski J, Seider M, Kim H, Kuban DA, Moughan J, Sandler H. 2015. A Phase 3 Trial of 2 Years of Androgen Suppression and Radiation Therapy With or Without Adjuvant Chemotherapy for High-Risk Prostate Cancer: Final Results of Radiation Therapy Oncology Group Phase 3 Randomized Trial NRG Oncology RTOG 9902. Int J Radiat Oncol Biol Phys [21 July 2015]. www.ncbi.nlm.nih.gov/pubmed/26209502