ORLANDO, FL, USA (UroToday.com) - The role of short-term androgen deprivation (STADT) in combination with radiation therapy (RT) for patents with intermediate-risk prostate cancer is controversial. The group presented the result of a prospective, randomized trial, which compares outcomes between patients with intermediate-risk prostate cancer with different doses of radiation therapy, with or without STADT, NCT 00223145.
From 2000 to 2010, 600 patients with intermediate-risk prostate cancer were randomized to 6 months of STADT and two levels of prostate RT doses of 70 (arm 1) or 76 Gy (arm 2) vs prostate dose-escalated RT alone at 76 Gy (arm 3). STADT consisted of bicalutamide and goseriline for 6 months. RT was administered 4 months after the beginning of STADT. Primary end-points were biochemical free survival (BFS) and disease-free survival (DFS), while overall-survival (OS) was a secondary end point.
At a median follow-up of 75.4 months, biochemical failure occurred in 14% of patients (arms 1 to 3: 12.5%, 8.0%, 21.5%) with statistical differences observed between arms 1 and 3 (p = 0.02) and arms 2 and 3 (p<0.001). A total of 113 (19%) patients died with only 6 (1%) patients dying from prostate cancer. The 5-/10-year DFS rates were 93%, 97.5% and 86%, and 77%, 90% and 64.5%, respectively. Significant differences in DFS between the treatment arms were observed at 5 years but at 10 years it was observed only between arms 1 and 3 (p=0.01) and arms 2 and 3 (p<0.001). The 5-/10-year OS rates were 91%, 95% and 93%, and 64%, 70% and 78%, respectively. There was no statistical difference in OS between arms at 5 and 10 years.
In conclusion, in patients with intermediate-risk prostate cancer, the use of STADT in combination with RT leads to improved BFS and DFS. However, these outcomes did not translate into an improved OS.
Presented by Abdenour Nabid, Nathalie Carrier, Eric Vigneault, Luis Souhami, Céline Lemaire, Marc-André Brassard, Boris Bahoric, Robert Archambault, François Vincent, and Thu-Van Nguyen-Huynh at the 2015 Genitourinary Cancers Symposium - "Integrating Biology Into Patient-Centric Care" - February 26 - 28, 2015 - Rosen Shingle Creek - Orlando, Florida USA
Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC, Canada; Centre Hospitalier Universitaire de Québec, Québec City, QC, Canada; Centre Universitaire de Santé McGill, Montreal, QC, Canada; Hôpital Maisonneuve-Rosemont de Montréal, Montréal, QC, Canada; Centre de Santé et Services Sociaux de Chicoutimi, Chicoutimi, QC, Canada; Hôpital Général Juif de Montréal, Montréal, QC, Canada; Hôpital de Gatineau, Gatineau, QC, Canada; Centre Hospitalier Régional de Trois-Rivières, Trois-Rivières, QC, Canada; Department of Radiation Oncology, Centre Hospitalier de l'Université de Montréal, Montreal University, Montreal, QC, Canada
Reported by Mohammed Haseebuddin, MD, medical writer for UroToday.com