In a new study from Northwestern University, researchers found that patients receiving radiotherapy to treat high-risk prostate cancer also benefit from androgen deprivation therapy.
The ideal duration of treatment may be roughly two years if receiving external beam radiation and one year if receiving external beam radiation with a brachytherapy boost.
Previous studies have shown that the use of androgen deprivation therapy (ADT) combined with radiation therapy improves cancer outcomes but comes with significant side effects.
The side effects include effects on the cardiovascular system, mood, lowered libido, and loss of muscle mass.
This forces clinicians and patients to weigh benefits versus costs for use and duration of treatment with androgen deprivation therapy.
High-risk prostate cancer is a disease with the ability to progress and spread outside of the prostate.
When clinically localized prostate cancer is treated with radiation, ADT, which cuts off the androgens that prostate cancer relies on, should be employed to optimize the treatment.
Current guidelines suggest 18 to 36 months of ADT, but given its adverse effects, it’s commonly administered in shorter durations than indicated.
In the current study, investigators sought to determine minimum thresholds of effectiveness as measured by improved survival among patients with high-risk prostate cancer.
The study included one retrospective cohort and two trial cohorts, totaling more than 3,400 patients.
Researchers found that longer durations of androgen deprivation therapy (ADT) were associated with increased survival.
Patients receiving external beam radiation therapy (EBRT) alongside ADT for 28 months had improved survival compared with patients receiving ADT for just 18 months.
This can be modified by additional therapies, as patients also undergoing brachytherapy may only need 12 months of ADT to see benefit.
However, for other patients, 18 months should be the floor and roughly two years of therapy is preferred.
The findings suggest that for men with high-risk non-metastatic prostate cancer receiving radiation therapy, the optimal length of androgen deprivation is likely over 18 months.
If you care about prostate cancer risk, please read studies that enlarged prostate may actually lower a man’s odds for cancer, and ‘gut bugs’ that could drive prostate cancer growth.
For more information about prostate cancer, please see recent studies about diet that could drive growth of prostate cancer, and results showing that new drug for treating aggressive prostate cancer.
The study was conducted by Amar U. Kishan et al., and published in JAMA Oncology.
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