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International meta-analysis quantifies impact of three prostate cancer therapy intensification strategies

An individual patient data (IPD) meta-analysis of randomized, controlled clinical trials provides strong evidence for the addition of androgen deprivation therapy (ADT) to definitive radiotherapy (RT) for the treatment of prostate cancer, with the projection that adding ADT to the treatment of 10-15 men would prevent the development of distant metastasis in one man. Similarly, if ADT has been added, prolonging the portion of it that follows the radiation (called “adjuvant ADT”) to 18-36 months provides a similar benefit in terms of preventing metastatic disease. The benefits of adding ADT and of prolonging adjuvant ADT were identified regardless of patient age, RT dose (high vs. low), or prostate cancer risk group (high vs. intermediate risk). In contrast, prolongation of ADT that begins before radiation (called “neoadjuvant ADT”) beyond two to three months did not improve any cancer outcome, according to the study, prompting researchers to conclude that the latter treatment should not routinely be employed. Read More

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