The Benefit of Short-Term Androgen Deprivation Therapy with Radiation Therapy for Intermediate-Risk Prostate Cancer.

Document Type

Article

Publication Date

6-1-2025

Publication Title

International journal of radiation oncology, biology, physics

Abstract

PURPOSE: A previous, individual patient-level meta-analysis of randomized controlled trials (RCTs) demonstrated the overall survival (OS) benefit of short-term androgen deprivation therapy (ST-ADT) when delivered with radiation therapy (RT) for the subset of patients with intermediate-risk prostate cancer (IR-PCa). However, because of inclusion criteria, several studies such as NRG/RTOG 0815, GETUG-14, and DFCI 95-096 were excluded. Thus, we conducted the present analysis, inclusive of all studies to define the current role of ST-ADT in IR-PCa.

METHODS AND MATERIALS: A systematic review was conducted of phase 3 RCTs published or presented between January 1980 and October 2024 which profiled the comparative efficacy of radiation therapy ± ST-ADT in patients with IR-PCa. A study-level, random-effects meta-analysis was performed. The primary endpoint of this meta-analysis was OS, with secondary endpoints of time-to-biochemical failure (BF) ± biochemical-progress-free survival (bPFS). Meta-regression was used to explore trial-level factors associated with treatment effects. Synthetic individual patient-level OS data were pooled for confirmation and used to estimate the relative and absolute survival benefit.

RESULTS: Seven RCTs (NRG/RTOG 9408, DFCI 95-096, TROG 96.01, PCS III, EORTC 22991, NRG/RTOG 0815, and GETUG-14) reporting outcomes of 6179 patients were identified. The pooled hazard ratios (HRs) for HR

CONCLUSIONS: The present analysis confirms current knowledge that ST-ADT improves both OS and prostate-specific antigen-based outcomes for unselected patients with IR-PCa to a clinically significant degree.

Volume

122

Issue

2

First Page

407

Last Page

415

DOI

10.1016/j.ijrobp.2025.01.022

ISSN

1879-355X

PubMed ID

39922318

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