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Renal & Urology NewsAdding ADT to Radiation Does Not Up Survival in Intermediate-Risk Prostate Cancer

Explore the role of androgen deprivation therapy in prostate cancer treatment and its impact on patient survival and oncologic benefits.

The recent NRG Oncology/Radiation Therapy Oncology Group study offers fresh insights on androgen deprivation therapy in prostate cancer treatment. The researchers focused on patients with intermediate-risk prostate cancer. They used a sample of 1,492 patients, randomly assigned to receive either escalated radiation therapy alone, or combined with short-term androgen deprivation therapy (ADT).

Strikingly, the results didn’t point to a significant survival advantage. The five-year survival estimates were almost identical for both groups, at 90% and 91% respectively. Yet, when it comes to oncologic benefits, adding short-term ADT had a substantial impact.

Importantly, this therapy reduced the risk for PSA relapse, distant metastasis, and prostate cancer-specific mortality by 48%, 75%, and 90% respectively. Also, patients on ADT exhibited a 38% lower risk of requiring salvage ADT.

However, physicians need to be aware of the potential drawbacks. The study observed that the adverse event rates were notably higher with ADT use, at 69% compared to 21% for radiation therapy alone. Indeed, 12% of the ADT group experienced acute grade 3 or higher adverse events, compared to just 2% of the radiation-only group.

Additionally, the ADT group reported clinically meaningful declines in hormonal and sexual quality of life in the short term. Fortunately, these effects diminished by one year. There were no discernible between-group differences in fatigue and bowel or urinary symptoms.

To sum up, the data from this study and its companion quality-of-life analysis will help clinicians counsel patients on the risks and benefits of adding short-term ADT to radiation therapy. It paves the way for patients to make more informed decisions, weighing clinical advantages against potential impacts on quality of life.

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