title: Short-term versus long-term hormone therapy plus radiotherapy or prostatectomy for prostate cancer: a systematic review and meta-analysis.
abstract: OBJECTIVE
  To compare the efficacy and safety of short-term versus long-term hormonotherapy (HT) plus radiotherapy (RT) or prostatectomy (RP) for prostate cancer.
  
  
  METHODS
  Literatures were searched from Embase, PubMed, Web of science and Cochrane Library up to October, 2012. Quality of the study was evaluated according to the Cochrane's risk of bias of randomized controlled trial (RCT); the Grading of Recommendations Assessment, Development and Evaluation System was used to rate the level of evidence. RevMan 5.1 was used for statistical analysis. Two comparisons were of interest: RT plus short-term HT versus RT plus long-term HT and RP plus short-term HT versus RP plus long-term HT. Pooled risk ratio or standardized mean differences were calculated; HT adverse reactions were descriptively evaluated.
  
  
  RESULTS
  Nine RCTs (total 4,743 patients) were included, 7 RCTs compared RT plus short-term HT with RT plus long-term HT, 2 RCTs compared RP plus short-term HT with RP plus long-term HT. Meta-analysis showed there was no significant difference in overall survival, disease-free survival and PSA level before RP; long-term was superior to short-term hormonotherapy in biochemical failure rate, clinical progression rate, prostate cancer-specific mortality, positive surgical margin rate and prostate volume before RP. Systematic review demonstrated adverse events caused by the increased length of HT were more common.
  
  
  CONCLUSIONS
  Long-term HT plus RT showed a trend toward improved overall survival; long-term HT plus RP declined positive surgical margin rate and prostate volume before RP. So, long-term HT may benefit more, but it did not significantly improve the patients' overall survival, and the adverse reactions are inevitable.
authors: Department of Radiation Oncology, Cancer Hospital of Guangxi Medical University, Cancer Institute of Guangxi Zhuang Autonomous Region, No.71, Hedi Road, Nanning 530021, People's Republic of China.
authors: Zhi-Rui
authors: ZR
authors: Zhou
authors: Xiao-Dong
authors: XD
authors: Zhu
authors: Jun
authors: J
authors: Xia
authors: Zhang-Yu
authors: ZY
authors: Zou
authors: Song
authors: S
authors: Qu
authors: Xian-Tao
authors: XT
authors: Zeng
authors: Zhi
authors: Z
authors: Mao
authors: Zhong-Guo
authors: ZG
authors: Liang
mesh_terms: D018931:Antineoplastic Agents, Hormonal / Q000009:adverse effects; D018450:Disease Progression; D006801:Humans; D008297:Male; D009929:Organ Size; D011467:Prostate / Q000473:pathology / Q000601:surgery; D017430:Prostate-Specific Antigen / Q000378:metabolism; D011468:Prostatectomy / Q000009:adverse effects; D011471:Prostatic Neoplasms / Q000401:mortality / Q000628:therapy*; D018714:Radiotherapy, Adjuvant / Q000009:adverse effects; D017211:Treatment Failure
chemical_list: D018931:Antineoplastic Agents, Hormonal; D017430:Prostate-Specific Antigen
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