Korean J Urol.  2015 Oct;56(10):689-694. 10.4111/kju.2015.56.10.689.

The effect of continuous androgen deprivation treatment on prostate cancer patients as compared with intermittent androgen deprivation treatment

• Ku JY
• Lee JZ
• Ha HK

• KMID: 2344111
• DOI: http://doi.org/10.4111/kju.2015.56.10.689

Abstract

PURPOSE
To investigate the efficacy of androgen deprivation treatment (ADT) between continuous and intermittent ADT.
MATERIALS AND METHODS
Between January 2006 and May 2015, 603 patients were selected and divided into continuous ADT (CADT) (n=175) and intermittent ADT (IADT) (n=428) groups. The median follow-up in this study was 48.19 (1.0-114.0) months. The primary end point was time to castration resistant prostate cancer (CRPC). The types of ADT were monotherapy and maximal androgen blockade (i.e., luteinizing hormone-releasing hormone agonist and antiandrogen).
RESULTS
The characteristics of patients showed no significant differences between the CADT and IADT groups, except for the Gleason score (p<0.001). The median time to CRPC of all enrolled patients with ADT was 20.60±1.60 months. The median time to CRPC was 11.20±1.31 months in the CADT group as compared with 22.60±2.08 months in the IADT group. In multivariate analysis, percentage of positive core (p=0.047; hazard ratio [HR], 0.976; 95% confidence interval [CI], 0.953-1.000), Gleason score (p=0.007; HR, 1.977; 95% CI, 1.206-3.240), lymph node metastasis (p=0.030; HR, 0.498; 95% CI, 0.265-0.936), bone metastasis (p=0.028; HR, 1.921; 95% CI, 1.072-3.445), and CADT vs. IADT (p=0.003; HR, 0.254; 95% CI. 0.102-0.633) were correlated with the duration of progression to CRPC. The IADT group presented a significantly longer median time to CRPC compared with the CADT group. Additionally, patients in the IADT group showed a longer duration in median time to CRPC in subgroup analysis according to the Gleason score.
CONCLUSIONS
This study found that IADT produces a longer duration in median time to CRPC than does CADT.

Keyword

Androgens; Castration-resistant prostatic neoplasms; Prostatic neoplasms; Therapeutics; Treatment outcome

MeSH Terms

Adenocarcinoma/*drug therapy/pathology/secondary
Aged
Aged, 80 and over
Androgen Antagonists/*administration & dosage/therapeutic use
Antineoplastic Agents, Hormonal/*administration & dosage/therapeutic use
Disease Progression
Drug Administration Schedule
Follow-Up Studies
Humans
Lymphatic Metastasis
Male
Middle Aged
Neoplasm Grading
Prostatic Neoplasms/*drug therapy/pathology
Prostatic Neoplasms, Castration-Resistant/drug therapy/pathology
Retrospective Studies
Treatment Outcome
Androgen Antagonists
Antineoplastic Agents, Hormonal

Figure

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  Fig. 1 Comparison of efficacy between continuous ADT and intermittent ADT group in all patients. CRPC, castration resistant prostate cancer; ADT, androgen deprivation treatment.

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  Fig. 2 Comparison of efficacy between continuous ADT and intermittent ADT group in patients. (A) Low and intermittent Gleason score, (B) high Gleason score. CRPC, castration resistant prostate cancer; ADT, androgen deprivation treatment.

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