ADT Plus Radiotherapy Tied to Improved Prostate CA Survival

Better survival with androgen deprivation therapy, radiotherapy combo for locally advanced cancer

THURSDAY, Nov. 3 (HealthDay News) -- The addition of radiotherapy (RT) to androgen deprivation therapy (ADT) is associated with improved overall survival in patients with locally advanced prostate cancer, according to a study published online Nov. 3 in The Lancet.

Padraig Warde, M.B., from the Princess Margaret Hospital in Toronto, and colleagues investigated the effects of adding RT to ADT on survival in men with locally advanced prostate cancer. Outcomes were evaluated in an interim analysis, for patients with: locally advanced prostate cancer (1,057 patients); organ-confined disease with a prostate-specific antigen (PSA) concentration more than 40 ng/mL (119); or organ-confined disease with a PSA concentration of more than 20 ng/mL and a Gleason score of 8 or higher (25). A total of 1,205 patients were randomly assigned between 1995 and 2005 to receive lifelong ADT only versus ADT with RT (602 and 603 men, respectively), and were followed up for a median of six years. Overall survival was the primary end point.

The investigators found that 320 patients died at the time of analysis, including 175 in the ADT-only group and 145 in ADT and RT group. Overall survival at seven years improved for the ADT and RT group, compared to the ADT-only group (74 versus 66 percent; hazard ratio, 0.77). Toxicity and health-related quality-of-life results indicated only a small effect of RT on late gastrointestinal or genitourinary toxicity.

"The benefits of combined modality treatment -- ADT and RT -- should be discussed with all patients with locally advanced prostate cancer," the authors write.

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