Is the long term burden of ADT plus radiotherapy worse than ADT alone?

When this study started back in 1995, RT was known to have harmful side effects but it was not clear that adding radiotherapy (RT) to ADT would improve survival significantly. This study is a definitive report on over 1000 patients, who were randomly assigned to either ADT or ADT+RT, and then followed up for a median of six years. Although the patients experienced the side effects of both ADT and RT in the short term, the study showed the clear benefit of the dual treatment.

The focus here was on patient-reported outcomes, which are often collectively called health-related quality of life (HRQOL). As expected, at 6 months after treatment the patients receiving RT+ADT had more bowel and bladder symptoms. But by 2 years, the differences between the two groups disappeared.

Since the study began, there have been many advances in RT. Similarly, the conditions for administering ADT have also been better (and more narrowly) defined. Nevertheless it is nice to see this large study on ADT and HRQOL completed with a positive outcome. 


Brundage M, Sydes MR, Parulekar WR, Warde P, Cowan R, Bezjak A, Kirkbride P, Parliament M, Moynihan C, Bahary JP, Parmar MK, Sanders K, Chen BE, Mason MD. 2015. Impact of radiotherapy when added to androgen-deprivation therapy for locally advanced prostate cancer: long-term quality-of-life outcomes from the NCIC CTG PR3/MRC PR07 randomized trial. J Clin Oncol 33(19):2151-2157.