Several studies have tested the addition of adjuvant radiotherapy (RT) to androgen deprivation therapy (ADT) in node-positive prostate cancer (PCa) after radical prostatectomy (RP). This meta-analysis aims to assess the effects of adding RT to ADT in the treatment of PCa patients with lymph node invasion.
We systematically searched PubMed and Embase through June 2018 for human studies comparing RT plus ADT versus ADT in men with node-positive PCa after RP. The primary end point was overall survival (OS). Secondary end point was cancer-specific survival (CSS). Hazard ratios (HRs) with 95% confidence intervals (CIs) for the effects of RT plus ADT on OS and CSS were combined across studies using meta-analysis.
Five studies were selected for inclusion. Overall, 15,524 patients were enrolled in the 5 studies. This included 6309 (40.6%) patients receiving ADT, 4389 (28.3%) patients receiving adjuvant RT plus ADT, and 4826 (31.1%) patients receiving observation. In lymph node-positive PCa patients, the addition of adjuvant RT was associated with improved OS (HR: 0.74; 95% CI, 0.59-0.92; P = .008). Moreover, the addition of adjuvant RT was also associated with a dramatic CSS improvement (HR: 0.40; 95% CI, 0.27-0.59; P = .000).
Adding RT to ADT may be a clinically effective treatment option for men with lymph node-positive PCa after RP.
Medicine. 2020 Mar [Epub]
Lijuan Guo, Zhaowei Zhu, Xuepei Zhang
Department of Disease Prevention and Control., Department of Urology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, PR China.