title: Optimal duration of androgen deprivation therapy following radiation therapy in intermediate- or high-risk nonmetastatic prostate cancer: A systematic review and metaanalysis.
abstract: OBJECTIVE
  To investigate current evidence on the optimal duration of adjuvant hormone deprivation for prostate cancer treated with radiation therapy with curative intent.
  
  
  METHODS
  A systematic search was performed in electronic databases. Data from randomized trials comparing different durations of hormone blockade was collected for pooled analysis. Overall survival, disease-free survival, disease-specific survival and toxicity were the outcomes of interest. Meta-analyses were performed using random-effects model.
  
  
  RESULTS
  Six studies met the eligibility criteria. For overall survival, the pooled data from the studies demonstrated a statistically significant benefit for longer hormone deprivation (Hazard Ratio 0.84; 95% CI 0.74 - 0.96). A statistically significant benefit was also found for disease-free survival (Hazard Ratio 0.74; 95% CI 0.62 - 0.89), and disease-specific survival (Hazard Ratio 0.73; 95% CI 0.62 - 0.85). Studies with longer blockade duration arm demonstrated greater benefit. Toxicity was low, with no increase in cardiovascular events.
  
  
  CONCLUSIONS
  Longer duration of androgen deprivation combined to radiotherapy prolongs OS, DFS and DSS in patients with intermediate and high-risk non-metastatic prostate cancer. However, this evidence is based on trials using older radiation techniques, and further research of combination of androgen deprivation and new RT technologies may be warranted.
authors.affiliation: State University of Campinas, UNICAMP, SP, Brazil.
authors.forename: Frederico
authors.initials: F
authors.lastname: Leal
authors.affiliation: State University of Campinas, UNICAMP, SP, Brazil.
authors.forename: Maximiliano Augusto Novis de
authors.initials: MA
authors.lastname: Figueiredo
authors.affiliation: State University of Campinas, UNICAMP, SP, Brazil.
authors.forename: Andre Deeke
authors.initials: AD
authors.lastname: Sasse
mesh_terms: D000726:Androgen Antagonists / Q000627:therapeutic use*; D017024:Chemotherapy, Adjuvant / Q000379:methods; D018572:Disease-Free Survival; D006801:Humans; D008297:Male; D020360:Neoadjuvant Therapy / Q000379:methods; D011379:Prognosis; D011471:Prostatic Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000532:radiotherapy*; D016032:Randomized Controlled Trials as Topic; D015203:Reproducibility of Results; D018570:Risk Assessment; D013997:Time Factors
chemical_list: D000726:Androgen Antagonists