What is the best duration of ADT when used in conjunction with external beam radiation?

Assessing the Optimum Use of Androgen-Deprivation Therapy in High-Risk Prostate Cancer Patients Undergoing External Beam Radiation Therapy. By Ludwig et al. 2015

 

Key sentence from the paper: “This study supports the use of ADT for all high-risk PCa patients treated with [external beam radiation therapy], particularly in those receiving lower dose of radiation.”

 

For the full abstract, see: http://www.ncbi.nlm.nih.gov/pubmed/25891393

 

Commentary: This study is a retrospective analysis of 1290 patients with high risk prostate cancer, who were all treated before 2010. The authors conclude that patients receiving external beam radiotherapy, who received two years or more of ADT, had lower risk of biochemical failure than those receiving ADT for a shorter period of time.

However in the last half decade there has been increased use of high- versus low-dose radiotherapy. With careful selection of patients, there is a growing sense that the benefit of ADT, when used as an adjuvant to radiotherapy, can be effective with less than two years of administration.

It should also be noted that this study only looked at biochemical failure and did not look at overall survival. Because it is survival that matters most—and long-term use of ADT has not been proven to be substantially more beneficial than short term use—the results of this paper are mostly of historical interest. They do not support changes in the current recommendations for the use of ADT with external beam radiotherapy.

  

Ludwig MS, Kuban DA, Strom SS, Du XL, Lopez DS, Yamal JM. 2015. Assessing the Optimum Use of Androgen-Deprivation Therapy in High-Risk Prostate Cancer Patients Undergoing External Beam Radiation Therapy. Am J Mens Health. 19 April 2015 [Epub ahead of print]