ASCO GU 2008 - Radiation Therapy: How Much Androgen Deprivation Therapy Is Enough?

Main Category: Urology / Nephrology
Also Included In: Cancer / Oncology;  Radiology / Nuclear Medicine
Article Date: 17 Feb 2008 - 0:00 PDT

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UroToday.com - Dr. Sandler reported on a secondary analysis of RTOG 85-31, in which the patients who got longer duration of ADT had better survival. In RTOG 9202, 1,554 men with T3 disease had either ADT for a mean of 28 months vs. short term ADT and there was a PCSM benefit to long term therapy. The benefit is seen most in high-risk patients. In the Harvard trial updated by D'Amico, there is a persistent PCSM advantage to those who received 6 months ADT vs. no ADT. In EORTC 22961 as reported by Bolla at ECCO, 970 men were randomized to short vs. long term hormone therapy. 132 men died in the short ADT arm, significantly worse than the long-term arm. Many patients in all the radiotherapy trials Dr. Sandler reviewed have bulky disease, and as such are more likely to benefit from longer term ADT. For non-PSA failure endpoints, short-term ADT is better than no ADT, and long-term ADT is better than either no ADT or short-term ADT. In the long term arms, it appears that we are unable to determine whether 28 months or 36 months is better. Thus 28-36 months is better for high-risk patients.

Presented by Howard Sandler at the American Society of Clinical Oncology (ASCO) - 2008 Genitourinary Cancers Symposium - A Multidisciplinary Approach - February 14-16, 2008 San Francisco, California, USA

Reported by UroToday.com Contributing Editor Christopher P. Evans, MD, FACS Professor & Chairman Department of Urology University of California, Davis, School of Medicine Sacramento, CA

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