Adding ADT to Radiotherapy Increases Metastasis-Free Survival in Prostate Cancer

A study shows that adding androgen-deprivation therapy (ADT) to radiotherapy and adjuvant therapy ADT prolongation enhances metastasis-free survival in men with localized prostate cancer. The results appeared in The Lancet Oncology.

In this study, researchers conducted a meta-analysis to assess the benefit of several ADT intensification strategies in men receiving radiotherapy for treatment of prostate cancer, both in aggregate and subgroup analysis. In total, collated data from 12 trials, which yielded on 10,853 patients, with a median follow-up of 11.4 years.

According to the results, there were marked improvements in metastasis-free survival with the addition of ADT to radiotherapy (hazard ratio=0.83; 95% CI, 0.77 to 0.89; P < 0.0001) and for adjuvant ADT prolongation (HR= 0.84; 95% CI, 0.78 to 0.91; P < 0.0001), but not for neoadjuvant ADT extension (HR=0.95; 95% CI, 0.83 to 1.09; P = 0.50). The researchers observed that ADT treatments were similarly efficacious, regardless of radiotherapy dose, patient age, or National Comprehensive Cancer Network risk group.

“We provide the strongest level of evidence for the routine recommendation for the addition of ADT to radiotherapy in men with intermediate-risk disease, and the use and prolonged adjuvant ADT for men with high-risk disease, irrespective of radiotherapy dose,” the authors concluded. “However, the strategy of prolongation of neoadjuvant ADT should not be routinely recommended.”