Shorter ADT Linked to Fewer Quality-of-Life Impacts
Shorter Androgen Deprivation Therapy Linked to Fewer Quality-of-Life Impacts
SAN FRANCISCO—Shorter-duration androgen deprivation therapy (ADT) following radiotherapy for patients with high-risk prostate cancer is associated with better patient-reported quality-of-life outcomes, according to results of a phase 3 randomized trial presented during the 2014 Genitourinary Cancers Symposium.
“In high-risk prostate cancer treated with radiotherapy and ADT, reducing the duration of ADT from 36 to 18 months improves quality of life, without a negative impact on survival,” reported lead study author Abdenour Nabid, MD, of the Centre Hospitalier, Universitaire de Sherbrooke, in Quebec, Canada, and coauthors.
A total of 630 patients with high-risk prostate cancer were randomly assigned to receive radiotherapy plus 36 months (n = 310) or 18 months (n = 320) of ADT. Patients' quality of life was assessed using the validated EORTC30 and PR25 patient-reported outcomes tools before treatments, every 6 months during ADT, 4 months after that, and once a year for 5 years. Quality-of-life measures were transformed into a scale of 0 to 100 points.
At a median follow-up of 79 months, the authors found no difference in survival outcomes for the two study arms, the team reported.
Several quality-of-life measures were worse (P < 0.01) for patients in the 36-month ADT arm than the 18-month arm, including physical, emotional, social and sexual function, fatigue, hormone treatment-associated symptoms, weakness, worry, irritation, and depression.
However, at 79 months, the study identified no “clinically relevant” differences (defined as mean differences in scores of 10 points or more). Sexual activity and interest in sex neared the clinical-relevance threshold, with 8.1- and 9.9-point differences reflecting worse outcomes for patients who received ADT for 36 months.
At 42 months, there was a 24-point difference in hot flushes and an 18-point difference for reports of “enjoyable sex,” both favoring shorter, 18-month ADT, the authors noted.
The study was funded by AstraZeneca.
The 2014 Genitourinary Cancers Symposium is sponsored by the the American Society of Clinical Oncology (ASCO), the American Society for Radiation Oncology (ASTRO), and the Society of Urologic Oncology (SUO).