Long-term androgen deprivation beneficial for prostate cancer with high PSA

Regardless of Gleason score or tumor stage, long-term androgen deprivation therapy improves the survival of prostate cancer patients presenting with a PSA level > 20 ng/mL, according to a report in the November 1st issue of the International Journal of Radiation Oncology, Biology, Physics.

Previous reports have suggested a survival benefit with long-term androgen deprivation, but it was unclear if this applied to all patients or only those with a high Gleason score, lead author Dr. Eric Berthelet, from the British Columbia Cancer Agency (BCCA) in Victoria, Canada, and colleagues note.The present study involved 307 patients who were treated with external beam radiotherapy and entered in the Prostate Cancer Outcomes Initiative database of the BCCA.Roughly half of the patients received short-term androgen deprivation therapy (ST-AD), defined as less than 12 months, and half received therapy for longer durations (LT-AD). The groups were comparable in terms of Gleason score and tumor stage distributions, the authors note.Patients in the ST-AD and LT-AD groups were followed for a median of 48 and 45 months, respectively. The median androgen deprivation duration in the ST-AD group was 6 months, whereas the median duration in the LT-AD group was 25.6 months.Overall, 62.5% of LT-AD patients had no biochemical evidence of disease compared with just 37% of ST-AD patients (p < 0.0001). Moreover, the 5-year overall and cause-specific survival rates in the LT-AD group were 87.5% and 94%, respectively, both significantly higher than the rates seen in the ST-AD group -- 75% and 82%."This study proves that long-term hormone therapy used in consort with radiation therapy improves survival rates for high-risk patients, regardless of their Gleason score or tumor stage," Dr. Berthelet said in a statement. (Source: Int J Radiat Oncol Biol Phys 2005;63:781-787: Reuters Health: Oncolink: November 2005.)