Short-term ADT leads to worse survival in prostate cancer patients on IMRT

Short-term concurrent androgen deprivation therapy (ADT) results in markedly worse overall survival (OS) among intermediate-risk (IR) prostate cancer patients on dose-escalated intensity modulated radiation therapy (IMRT) with daily image-guided RT, reveals a study.

This single-institution retrospective analysis evaluated outcomes of IR patients treated with dose-escalated IMRT with or without concurrent/adjuvant short-term ADT.

Data from 260 consecutive patients treated with dose-escalated IMRT with daily image-guided RT for newly diagnosed IR prostate cancer were obtained for analysis. Using Kaplan-Meier methodology, the authors calculated biochemical recurrence-free survival (BCRFS), distant metastasis-free survival, prostate cancer-specific survival, and OS. Median follow-up was 93 months.

Of the patients, 181 had unfavourable IR disease. ADT was given to 94 patients (36.2 percent) over a median duration of 6 months. Seven-year BCRFS was 94.1 percent for ADT and 86.2 percent for no ADT (p=0.067). No significant between-group difference was noted in distant metastasis-free survival or prostate cancer-specific survival.

ADT correlated with a significantly worse 7-year OS (80.0 percent vs 91.3 percent; p=0.010). Similar results were obtained in the analysis of the unfavourable IR cohort alone. In patients who received ADT and no ADT, the 7-year BCRFS was 93.7 percent vs 85.9 percent (p=0.093), respectively, and the corresponding 7-year OS was 79.0 percent vs 90.6 percent (p=0.019).

“Additional studies are needed to determine if ADT is beneficial or detrimental for patients with IR prostate cancer treated with dose-escalated radiation,” the authors said.