Major finding: Intermediate-risk group of patients with localized prostate cancer benefit from combined radiotherapy and short-term ADT.
Clinical outcome: Combined radiotherapy with ADT resulted in 10-year overall survival of 62%.
Future direction: Optimal radiation dose for these patients must be determined and longer follow-up may be required to observe benefits in patients with low-risk disease.
External beam radiation therapy plus androgen-deprivation therapy (ADT) is standard of care for men with advanced localized adenocarcinoma of the prostate, and it has been suspected but not known whether this combined therapy would be effective among patients with early localized disease. Jones and colleagues report on a phase III study of 1,979 patients with early-stage prostate adenocarcinoma treated either with radio-therapy alone or radiotherapy plus ADT with a mean follow-up of 9.1 years. The addition of ADT was associated with an improvement in the primary endpoint, 10-year overall survival, from 57% to 62%. Secondary endpoints including disease-specific mortality, distant metastases, increasing prostate-specific antigen levels, and positive findings on repeat biopsies were also significantly improved. Risk analysis showed that improvements in overall survival and disease-specific mortality were seen primarily among intermediate-risk patients, with no significant reductions among low-risk patients.
Note: Research Watch is written by Cancer Discovery Editors. Readers are encouraged to consult the articles referred to in each item for full details on the findings described.
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