Quality of life in patients with high-risk prostate cancer improves with shorter course of androgen deprivation therapy.

Abstract

A shorter course of androgen deprivation therapy (ADT) combined with radiotherapy (RT) leads to a quicker recovery of normal testosterone levels in patients with prostate cancer, resulting in better quality of life without affecting longterm outcomes, new research has found. The research, presented at the American Society for Radiation Oncology annual meeting (held in September, 2014 in San Francisco, California), analyzed data from 561 patients with high-risk prostate cancer in a multicenter, randomized phase 3 trial in Canada. Patients were randomized into 2 groups: one receiving 18 months of ADT and RT and the other receiving 36 months of ADT and RT. RT was initiated 4 months after the start of ADT in both groups. With a median follow up of 84 months, 55.7% of patients in the 18-month ADT group recovered to normal testosterone levels compared with 44.9% of patients in the 36-month ADT group. Furthermore, the median time to testosterone recovery was shorter in the patients receiving 18 months versus those receiving 36 months of ADT (47.2 months vs 73.2 months). Patients completed quality-of-life questionnaires prior to treatment, every 6 months during ADT, at 4 months after ADT, and then once a year for 5 years after treatment. As determined by the questionnaires, patients who had testosterone recovery had a better quality of life than those who did not. Currently, the ADT duration guideline for patients with high-risk prostate cancer is between 2 to 3 years. Because of the improvement in testosterone recovery and quality of life, the researchers say that 2 years of ADT may be a good step until final results are obtained.