1. Eur Urol. 2018 Oct;74(4):432-441. doi: 10.1016/j.eururo.2018.06.018. Epub 2018
Jul 3.

Duration of Androgen Deprivation Therapy in High-risk Prostate Cancer: A
Randomized Phase III Trial.

Nabid A(1), Carrier N(2), Martin AG(3), Bahary JP(4), Lemaire C(5), Vass S(6),
Bahoric B(7), Archambault R(8), Vincent F(9), Bettahar R(10), Duclos M(11),
Garant MP(2), Souhami L(11).

Author information: 
(1)Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC, Canada.
Electronic address: abdenour.nabid@usherbrooke.ca.
(2)Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC, Canada.
(3)Centre Hospitalier Universitaire de Québec, Québec city, QC, Canada.
(4)Centre Hospitalier Universitaire de Montréal, Montréal, QC, Canada.
(5)Hôpital Maisonneuve-Rosemont de Montréal, Montréal, QC, Canada.
(6)Centre de Santé et Services Sociaux de Chicoutimi, Chicoutimi, QC, Canada.
(7)Hôpital Général Juif de Montréal, Montréal, QC, Canada.
(8)Hôpital de Gatineau, Gatineau, QC, Canada.
(9)Centre Hospitalier Régional de Trois-Rivières, Trois-Rivières, QC, Canada.
(10)Centre Hospitalier Régional de Rimouski, Rimouski, QC, Canada.
(11)McGill University Health Centre, Montréal, QC, Canada.

Comment in
    Eur Urol. 2018 Oct;74(4):442-443.
    Eur Urol. 2019 Mar;75(3):e61-e62.
    Eur Urol. 2019 Mar;75(3):e63.

BACKGROUND: Long-term androgen deprivation therapy (ADT) combined with
radiotherapy (RT) is a standard treatment for patients with localized high-risk
prostate cancer (HRPC). However, the optimal duration of ADT is not yet defined.
OBJECTIVE: The aim of this superiority randomized trial was to compare outcomes
of RT combined with either 36 or 18 mo of ADT.
DESIGN, SETTING AND PARTICIPANTS: From October 2000 to January 2008, 630 patients
with HRPC were randomized, 310 to pelvic and prostate RT combined with 36 mo
(long arm) and 320 to the same RT with 18 mo (short arm) of ADT.
OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Overall survival (OS) and quality 
of life (QoL) were primary end points. OS rates were compared with Cox Regression
model and QoL data were analyzed through mixed linear model.
RESULTS AND LIMITATIONS: With a median follow-up of 9.4 yr, 290 patients had died
(147 long arm vs 143 short arm). The 5-yr OS rates (95% confidence interval) were
91% for long arm (88-95%) and 86% for short arm (83-90%), p=0.07. QoL analysis
showed a significant difference (p<0.001) in six scales and 13 items favoring 18 
mo ADT with two of them presenting a clinically relevant difference in mean
scores of ≥10 points.
CONCLUSIONS: In localized HRPC, our results support that 36 mo is not superior to
18 mo of ADT. ADT combined with RT can potentially be reduced to 18 mo in
selected men without compromising survival or QoL. Thus, 18 mo of ADT appears to 
represent a valid option in HRPC.
PATIENT SUMMARY: In this study, we report outcomes from high-risk prostate cancer
patients treated with radiotherapy and either 36 or 18 mo of androgen deprivation
therapy. There was no difference in survival between the two groups, with the
18-mo group experiencing a better quality of life.

Copyright © 2018 European Association of Urology. Published by Elsevier B.V. All 
rights reserved.

DOI: 10.1016/j.eururo.2018.06.018 
PMID: 29980331  [Indexed for MEDLINE]