At the European Association of Urology’s 23rd Annual Congress there was an abstract presented (Abstract 186) that concluded that three-dimensional external beam radiation (EBRT) with 6 months of androgen deprivation therapy (ADT) for the treatment of patients with locally advanced prostate cancer shows significantly shorter patient survival than the same treatment followed by 3 years of adjuvant ADT (ADT).
The study was a randomized, noninferiority-desgn phase III clinical trial conducted in Amsterdam, the Netherland.
The current standard of care in Europe for men with locally advanced prostate cancer is EBRT plus 3 years of a hormonal blockade. Dr. Theo De Reyke, Ph.D., one of the principle investigators, felt that three of ADT could have significant nonreversible side effects on the patient, which might be able to be avoided. As an alternative, he wanted to know if only six months of ADT would be a good alternative to the full three years of treatment.
His study initially had 1114 subjects who initially combined EBRT (51 days of treatment with a median total dose of 70 Gy) and 6 months of ADT. At the completion of the six months of ADT, 487 of the subjects were then continued on the ADT for an additional 2.5 years.
Unfortunately, the group receiving only six months of ADT did much worse then the group receiving the full three years.
Following the interim analysis carried out in September 2006 by the independent data monitoring committee the trial was terminated early.
The subject group receiving the full three years of ADT showed a significant increase in their five-year survival rate. They also displayed a significantly slower rate of disease progression.
This means that the current standard of administering the full three years of ADT needs to remain in force. This is bad news for those of us who suffer from a hormone blockade.
Joel T Nowak MA, MSW
Leave A Comment