Intermittent androgen blockade or continuous androgen blockade in advanced prostate cancer: A meta-analysis of efficacy, quality of life and side effects - Abstract

PURPOSE: To compare the efficacy, quality of life (QoL) and side effects of intermittent androgen blockade (IAB) vs. continuous androgen blockade (CAB) as treatment of advanced prostate cancer (PCA).

METHODS: Using the search terms "advanced prostate cancer", "prostate cancer", "intermittent androgen blockade", "continuous androgen blockade", "randomized controlled trial" (RCT), the literature in Chinese and English language was searched in several databases to see for any difference between IAB and CAB concerning the effectiveness, QoL and side effects. Then, the studies to be included were identified according to previously established inclusion criteria, and those selected were assessed by methodological quality. Finally, the data of the studies included were extracted using self-tabulate tables, and the criteria of RCTs were studied. At the same time, odds ratio (OR) and weighted mean difference (WMD) of random effects model and fixed effects model were calculated to evaluate sensitivity.

RESULTS: There were 16 RCTs that compared IAB with CAB with a total of 3264 patients (1624 with IAB and 1640 with CAB). Pooled effects indicated no significant difference between IAB and CAB groups in terms of death and progression rate (OR=0.99, 95% CI 0.80-1.23, and OR=1.03, 95% CI 0.84-1.26 respectively). Calculated results indicated that QoL on sexual activity was significantly higher in the IAB group (OR=0.24, 95% Cl 0.17-0.33, p< 0.00001). Moreover, IAB could effectively reduce side effects.

CONCLUSION: The therapeutic efficacy (progression and death rate) was not significantly different between the IAB and CAB groups. However, IAB can effectively preserve the QoL (sexual life) and reduce the side effects. With analysis of more RCTs with strict design stronger evidence of the superiority of IAB could be proven.

Written by:
Zhu J, Wang Y, Xu S, Sun Z.   Are you the author?
Department of Urology, The People's Hospital of GuiZhou Provience, Guiyang, People's Republic of China.

Reference: J BUON. 2012 Apr-Jun;17(2):350-6.

PubMed Abstract
PMID: 22740217 Prostate Cancer Section