title: Comparison of intermittent and continuous androgen deprivation and quality of life between patients with locally advanced and patients with metastatic prostate cancer: a post hoc analysis of the randomized FinnProstate Study VII.
abstract: OBJECTIVE
  The aim of the study was to compare intermittent (IAD) and continuous (CAD) androgen deprivation therapy (ADT) between locally advanced (M0) and metastatic (M1) prostate cancer, and the effect of ADT on the quality of life.
  
  
  METHODS
  In total, 852 men with advanced prostate cancer were enrolled to receive goserelin acetate for 24 weeks. Of these, 554 patients whose prostate-specific antigen (PSA) decreased to less than 10 ng/ml or by at least 50% (<20 ng/ml at baseline) were randomized to IAD or CAD. In the IAD arm, ADT was resumed for at least 24 weeks whenever PSA increased to greater than 20 ng/ml or above baseline.
  
  
  RESULTS
  Median follow-up time was 65 months. Median times from randomization to progression, death, prostate cancer death and treatment failure in M0 and M1 patients were 46.8 and 21.4, 57.6 and 40.3, 59.5 and 40.7, and 41.9 and 20.0 months, respectively (p < 0.001). No significant differences emerged between IAD and CAD. ADT showed a beneficial effect on pain, activity limitation and social functioning in M1 patients, and a deleterious effect on physical capacity in M0 patients and on sexual functioning in both groups. IAD offered extra benefit for activity limitation, social functioning and recovery of sexual functioning.
  
  
  CONCLUSIONS
  IAD is as efficient as CAD in treatment of locally advanced and metastatic prostate cancer. ADT improves quality of life in M1 patients, with IAD offering extra benefit.
authors.affiliation: Department of Urology, Kuopio University Hospital , Kuopio , Finland.
authors.forename: Arto J
authors.initials: AJ
authors.lastname: Salonen
authors.forename: Kimmo
authors.initials: K
authors.lastname: Taari
authors.forename: Martti
authors.initials: M
authors.lastname: Ala-Opas
authors.forename: Anna
authors.initials: A
authors.lastname: Sankila
authors.forename: Jouko
authors.initials: J
authors.lastname: Viitanen
authors.forename: Seppo
authors.initials: S
authors.lastname: Lundstedt
authors.forename: Teuvo L J
authors.initials: TL
authors.lastname: Tammela
mesh_terms: D000368:Aged; D000726:Androgen Antagonists / Q000627:therapeutic use*; D018931:Antineoplastic Agents, Hormonal / Q000008:administration & dosage* / Q000009:adverse effects; D018450:Disease Progression; D018572:Disease-Free Survival; D005500:Follow-Up Studies; D017273:Goserelin / Q000008:administration & dosage* / Q000009:adverse effects; D006304:Health Status; D006801:Humans; D008297:Male; D009362:Neoplasm Metastasis; D010147:Pain Measurement; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000097:blood / Q000188:drug therapy* / Q000473:pathology*; D011788:Quality of Life; D019529:Sexuality; D058992:Social Participation; D015996:Survival Rate; D013997:Time Factors
chemical_list: D000726:Androgen Antagonists; D018931:Antineoplastic Agents, Hormonal; D017273:Goserelin; D017430:Prostate-Specific Antigen
keywords: androgen deprivation; intermittent therapy; metastatic status; prostate cancer; quality of life