title: A review of continuous vs intermittent androgen deprivation therapy: redefining the gold standard in the treatment of advanced prostate cancer. Myths, facts and new data on a ″perpetual dispute″.
abstract: OBJECTIVE
  To review the literature and present new data of continuous androgen deprivation therapy (ADT) vs intermittent androgen deprivation (IAD) as therapies for prostate cancer in terms of survival and quality of life and clarify practical issues in the use of IAD.
  
  
  METHODS
  We conducted a systematic search on Medline and Embase databases using ″prostatic neoplasm″ and ″intermittent androgen deprivation″ as search terms. We reviewed meta-analyses, randomised controlled trials, reviews, clinical trials and practise guidelines written in English from 2000 and onwards until 01/04/2013. Ten randomized controlled trials were identified. Seven of them published extensive data and results randomizing 4675 patients to IAD versus CAD. Data from the other three randomized trials were limited.
  
  
  RESULTS
  Over the last years studies confirmed that IAD is an effective alternative approach to hormonal deprivation providing simultaneously several potential benefits in terms of quality of life and cost effectiveness. Thus, in patients with non metastatic, advanced prostate cancer IAD could be used as standard treatment, while in metastatic prostate cancer IAD role still remains ambiguous.
  
  
  CONCLUSIONS
  Nowadays, revaluation of the gold standard of ADT in advanced prostate cancer appears essential. Recent data established that IAD should no longer be consi¬dered as investigational, since its effectiveness has been proven, especially in patients suffering from non-metastatic advanced prostate cancer.
authors.affiliation: Department of Urology, ″Koutlibanio″ General Hospital of Larisa, Larissa, Greece.
authors.forename: Zisis
authors.initials: Z
authors.lastname: Kratiras
authors.affiliation: Department of Urology and Neuro-urology, National Rehabilitation Center, Athens, Greece.
authors.forename: Charalampos
authors.initials: C
authors.lastname: Konstantinidis
authors.affiliation: Department of Urology, ″Koutlibanio″ General Hospital of Larisa, Larissa, Greece.
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Skriapas
mesh_terms: D000726:Androgen Antagonists / Q000008:administration & dosage* / Q000009:adverse effects; D018931:Antineoplastic Agents, Hormonal / Q000008:administration & dosage* / Q000009:adverse effects; D004334:Drug Administration Schedule; D006801:Humans; D008297:Male; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000188:drug therapy*; D011788:Quality of Life; D015203:Reproducibility of Results; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000726:Androgen Antagonists; D018931:Antineoplastic Agents, Hormonal; D017430:Prostate-Specific Antigen