Intermittent versus continuous androgen deprivation therapy to biochemical recurrence after external beam...

Area of Science:

• Urology
• Oncology
• Radiotherapy

Background:

• Prostate cancer management often involves androgen deprivation therapy (ADT).
• The optimal duration and schedule of ADT following external beam radical radiotherapy (EBRT) for biochemical failure (BF) remain subjects of investigation.
• Assessing both oncologic outcomes and patient-reported quality of life (QoL) is crucial for treatment decisions.

Purpose of the Study:

• To compare the efficacy and QoL outcomes of intermittent (6 months) versus continuous (36 months) ADT in patients with BF after EBRT.
• To determine if intermittent ADT is non-inferior to continuous ADT regarding biochemical control and QoL.

Main Methods:

• A non-inferiority randomized phase 3 trial involving 77 patients stratified by Gleason score.
• Patients received either intermittent (6 months) or continuous (36 months) ADT.
• Follow-up included PSA monitoring and QoL assessments (QLQ-C30, QLQ-PR-25) every 6 months for 3 years.

Main Results:

• Disease progression (DP) after ADT occurred in 3 patients (1 with distant metastases) in the intermittent group versus 0 in the continuous group.
• No statistically significant differences in QLQ-C30 and QLQ-PR-25 scores were observed between the intermittent and continuous ADT groups.
• Median follow-up was 48 months.

Conclusions:

• Intermittent ADT (6 months) demonstrates comparable QoL outcomes to continuous ADT (36 months) in patients with BF post-EBRT.
• While DP was observed in a small subset of the intermittent group, overall significant differences in DP and QoL were not detected between the schedules.
• These findings suggest that intermittent ADT may be a viable alternative for select patients, warranting further consideration in treatment protocols.