PURPOSE: To compare the efficacy and safety of short-term versus long-term hormonotherapy (HT) plus radiotherapy (RT) or prostatectomy (RP) for prostate cancer.
METHODS: Literatures were searched from Embase, PubMed, Web of science and Cochrane Library up to October, 2012. Quality of the study was evaluated according to the Cochrane's risk of bias of randomized controlled trial (RCT); the Grading of Recommendations Assessment, Development and Evaluation System was used to rate the level of evidence. RevMan 5.1 was used for statistical analysis. Two comparisons were of interest: RT plus short-term HT versus RT plus long-term HT and RP plus short-term HT versus RP plus long-term HT. Pooled risk ratio or standardized mean differences were calculated; HT adverse reactions were descriptively evaluated.
RESULTS: Nine RCTs (total 4,743 patients) were included, 7 RCTs compared RT plus short-term HT with RT plus long-term HT, 2 RCTs compared RP plus short-term HT with RP plus long-term HT. Meta-analysis showed there was no significant difference in overall survival, disease-free survival and PSA level before RP; long-term was superior to short-term hormonotherapy in biochemical failure rate, clinical progression rate, prostate cancer-specific mortality, positive surgical margin rate and prostate volume before RP. Systematic review demonstrated adverse events caused by the increased length of HT were more common.
CONCLUSIONS: Long-term HT plus RT showed a trend toward improved overall survival; long-term HT plus RP declined positive surgical margin rate and prostate volume before RP. So, long-term HT may benefit more, but it did not significantly improve the patients' overall survival, and the adverse reactions are inevitable.
Written by:
Zhou ZR, Zhu XD, Xia J, Zou ZY, Qu S, Zeng XT, Mao Z, Liang ZG. Are you the author?
Department of Radiation Oncology, Cancer Hospital of Guangxi Medical University, Cancer Institute of Guangxi Zhuang Autonomous Region, No.71, Hedi Road, Nanning, 530021, People's Republic of China.
Reference: J Cancer Res Clin Oncol. 2013 Feb 5. Epub ahead of print.
doi: 10.1007/s00432-013-1383-7
PubMed Abstract
PMID: 23380891
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