Androgenic suppression combined with radiotherapy for the treatment of prostate adenocarcinoma: a systematic reviewReport as inadecuate




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BMC Cancer

, 12:54

Clinical oncology

Abstract

BackgroundLocally advanced prostate cancer is often associated with elevated recurrence rates. Despite the modest response observed, external-beam radiotherapy has been the preferred treatment for this condition. More recent evidence from randomised trials has demonstrated clinical benefit with the combined use of androgen suppression in such cases. The aim of this meta-analysis is to compare the combination of distinct hormone therapy modalities versus radiotherapy alone for overall survival, disease-free survival and toxicity.

MethodsDatabases MEDLINE, EMBASE, LILACS, Cochrane databases and ClinicalTrials.gov were scanned for randomised clinical trials involving radiotherapy with or without androgen suppression in local prostate cancer. The search strategy included articles published until October 2011. The studies were examined and the data of interest were plotted for meta-analysis. Survival outcomes were reported as a hazard ratio with corresponding 95% confidence intervals.

ResultsData from ten trials published from 1988 to 2011 were included, comprising 6555 patients. There was a statistically significant advantage to the use of androgen suppression, in terms of both overall survival and disease free survival, when compared to radiotherapy alone. The use of long-term goserelin up to three years was the strategy providing the higher magnitude of clinical benefit. In contrast to goserelin, there were no trials evaluating the use of other luteinizing hormone-releasing hormone LHRH analogues as monotherapy. Complete hormonal blockade was not shown to be superior to goserelin monotherapy.

ConclusionsBased on the findings of this systematic review, the evidence supports the use of androgen suppression with goserelin monotherapy as the standard treatment for patients with prostate cancer treated with radiotherapy, which are at high risk of recurrence or metastases.

Electronic supplementary materialThe online version of this article doi:10.1186-1471-2407-12-54 contains supplementary material, which is available to authorized users.

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Author: André D Sasse - Elisa Sasse - Albertina M Carvalho - Ligia T Macedo

Source: https://link.springer.com/







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