Radiotherapy Plus GnRH Analogue Versus High Dose Bicalutamide: A Case Control Study

Area of Science:

• Oncology
• Radiation Oncology
• Urology

Background:

• Radiotherapy (RT) combined with adjuvant hormone therapy (HT) enhances prognosis for prostate cancer (PC) patients.
• Gonadotrophin-releasing hormone agonists (GnRHa), also known as luteinizing hormone-releasing hormone (LH-RH) analogues, represent the standard HT.
• High-dose antiandrogen therapy demonstrates survival benefits in locally advanced PC.

Purpose of the Study:

• To compare the efficacy of RT plus GnRHa versus RT plus bicalutamide in PC patients.
• To evaluate biochemical relapse-free survival in patients receiving different adjuvant HT regimens.

Main Methods:

• Retrospective review of 318 PC patients from an institutional database.
• Inclusion criteria: patients treated with definitive or postoperative RT +/- HT.
• Median follow-up duration of 56 months.

Main Results:

• Five-year biochemical relapse-free survival rates were comparable: 85.5% for GnRHa and 88.3% for bicalutamide (p=0.712).
• No statistically significant difference in relapse-free survival between the two treatment groups.

Conclusions:

• Bicalutamide can be considered an alternative adjuvant treatment to RT for PC patients who cannot tolerate GnRHa due to side effects.
• The findings support the need for randomized clinical trials to directly compare RT plus GnRHa and RT plus bicalutamide.