PMID- 10098424
OWN - NLM
STAT- MEDLINE
DCOM- 19990401
LR  - 20190708
IS  - 0360-3016 (Print)
IS  - 0360-3016 (Linking)
VI  - 43
IP  - 4
DP  - 1999 Mar 1
TI  - The role of androgen deprivation in the definitive management of clinically
      localized prostate cancer treated with radiation therapy.
PG  - 707-13
AB  - PURPOSE: Multiple studies exploring the use of androgen deprivation given in
      combination with radiotherapy (RT) for localized prostate cancer have reported
      significant improvements in the rates of local, regional, and biochemical control
      (BC). The impact of this therapeutic strategy on overall and cancer specific
      survival (CSS) has not been established, however. We performed a MEDLINE search
      of all available studies on this topic to determine if any conclusions could be
      reached on the efficacy of this treatment approach and the patients most suitable
      for its application. MATERIALS AND METHODS: A MEDLINE search was conducted to
      obtain all articles in the English language on the use of androgen deprivation in
      combination with RT for the treatment of localized prostate cancer. The medical
      subject headings (MeSH) used to search the MEDLINE database included: a)
      prostatic neoplasms; b) prostatic neoplasms/radiotherapy; c) prostatic
      neoplasms/androgen deprivation; d) hormone therapy; e) English; and f) 1980 to
      1998. RESULTS: A total of 14 retrospective studies were identified that compared 
      some form of androgen deprivation given in combination with RT. Most studies
      showed significant improvements in various measures of local/regional control and
      disease-free survival (DFS). Three of four studies that analyzed BC rates showed 
      significant improvements in this endpoint but conflicting results were obtained
      for overall survival (OS). No study showed an improvement in CSS. Six prospective
      randomized trials were identified that directly compared RT with or without
      androgen deprivation. Again, all six studies showed improvements in some measure 
      of local/regional control or DFS but only two studies showed an improvement in
      OS. One study reported a statistically significant improvement in CSS and another
      study showed an improvement in the rate of negative biopsies with combined
      treatment. CONCLUSIONS: When all available literature on androgen withdrawal
      given in combination with RT for the definitive treatment of localized prostate
      cancer was reviewed, no definite conclusions could be reached on the impact of
      this treatment approach on OS and CSS. However, local/regional control, DFS, and 
      BC were almost uniformly improved with the use of androgen withdrawal suggesting 
      that these impressive early results may translate into improved cure rates. Data 
      from recently initiated and completed randomized trials will be needed, however, 
      to define the impact of this approach on cancer specific mortality and the
      patients most suitable for it's use.
FAU - Vicini, F A
AU  - Vicini FA
AD  - Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI 48073,
      USA. fvicini@beaumont.edu
FAU - Kini, V R
AU  - Kini VR
FAU - Spencer, W
AU  - Spencer W
FAU - Diokno, A
AU  - Diokno A
FAU - Martinez, A A
AU  - Martinez AA
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PL  - United States
TA  - Int J Radiat Oncol Biol Phys
JT  - International journal of radiation oncology, biology, physics
JID - 7603616
RN  - 0 (Androgen Antagonists)
SB  - IM
MH  - Androgen Antagonists/*therapeutic use
MH  - Combined Modality Therapy
MH  - Humans
MH  - Male
MH  - *Orchiectomy
MH  - Prospective Studies
MH  - Prostatic Neoplasms/radiotherapy/*therapy
MH  - Randomized Controlled Trials as Topic
MH  - Retrospective Studies
EDAT- 1999/03/31 00:00
MHDA- 1999/03/31 00:01
CRDT- 1999/03/31 00:00
PHST- 1999/03/31 00:00 [pubmed]
PHST- 1999/03/31 00:01 [medline]
PHST- 1999/03/31 00:00 [entrez]
AID - S0360-3016(98)00513-6 [pii]
AID - 10.1016/s0360-3016(98)00513-6 [doi]
PST - ppublish
SO  - Int J Radiat Oncol Biol Phys. 1999 Mar 1;43(4):707-13. doi:
      10.1016/s0360-3016(98)00513-6.