Addition of Androgen Deprivation Therapy Improves Survival with Locally Advanced Prostate Cancer

Posted on October 8th, 2009 by

In men with locally advanced prostate cancer, the addition of androgen deprivation therapy to radiation therapy improves overall and progression-free survival without substantially affecting cardiovascular mortality. These results, based on close to 10 years of follow-up, were presented at a European cancer conference.

Among men with locally advanced prostate cancer, several clinical trials suggest that the results of radiation therapy can be improved with androgen suppression before, during, and/or after radiation therapy. However, there have been concerns about the long-term effects of ADT, which may include heart disease and osteoporosis.

To evaluate the addition of ADT to radiation therapy, researchers in Europe conducted a Phase III clinical trial (EORTC 22863) among 415 men with Stage I-II cancer and a high Gleason score, Stage III cancer, or Stage IV cancer without distant metastases.

Half the study participants were assigned to be treated with radiation therapy alone, and half were assigned to be treated with radiation therapy plus three years of ADT with Zoladex® (goserelin).

Study participants have now been followed for close to 10 years.

The following table summarizes the main findings of this study:

Radiotherapy + ADT Radiotherapy Alone
Number of deaths 80 112
10-year overall survival 58.1% 39.8%
10-year clinical progression-free survival 47.7% 22.7%
10-year distant metastasis-free survival 51.0% 30.2%
10-year biochemical progression-free survival 37.9% 17.6%
10-year cumulative prostate cancer mortality 11.1% 31%
10-year cardiovascular mortality 11.1% 8.2%
Pathological fractures 2 0

These updated results continue to suggest that the combination of radiation therapy and ADT results in better survival than radiation therapy alone among men with locally advanced prostate cancer. The risk of death from cardiovascular disease was not significantly different between men who did and did not receive three years of ADT.

Men with prostate cancer are advised to talk with their physician about the potential risks and benefits of all treatment options being considered.

Reference: Bolla M, Collette L, Van Tienhoven G, et al. Three years of adjuvant androgen deprivation with goserelin in patients with locally advanced prostate cancer treated with radiotherapy: Results at 10 years of EORTC trial 22863. European Journal of Cancer Supplements, Vol 7 No 2, September 2009, page 408, abstract O-7007.

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