Optimal duration of androgen deprivation therapy for moderate and high risk prostate cancer after radiotherapy: A Meta-analysis / 肿瘤

ABSTRACT

Objective: To systematically evaluate the optimal duration of adjuvant androgen deprivation therapy (ADT) after radiotherapy for prostate cancer. Methods: The CBM, CNKI, Wanfang, PubMed, EMbase, Cochrane Library, Clinical Trials.gov databases were searched by computer. The randomized controlled trial (RCT) on long-term and shortterm ADT for intermediate and high risk non-metastatic prostate cancer after radiotherapy were collected. The retrieval time was from the establishment of these databases to November 5, 2018. After independent screening literature, extracting data and evaluating the quality of the included studies, two researchers used RevMan 5.3 software for Meta-analysis. Results: A total of eight RCTs were selected, including 6 165 patients. Meta-analysis showed that the overall survival (OS) rate in longterm ADT group was higher than that in short-term treatment group [hazard ratio (HR) = 0.75, 95% confidence interval (CI) 0.63-0.89, P = 0.000 7]; the disease-free survival (DFS) rate in long-term ADT group was higher than that in short-term treatment group (HR = 0.81, 95% CI 0.70-0.94, P = 0.007); the disease-specific survival (DSS) in long-term ADT group was higher than that in short-term treatment group (HR = 0.83, 95% CI 0.71-0.96, P = 0.01); the local progress (LP) in long-term ADT group was lower than that in short-term treatment group [relative risk (RR) = 0.76, 95% CI 0.59-0.97, P = 0.03]; the biochemical failure (BF) in long-term ADT group was lower than that in short-term treatment group (RR = 0.66, 95% CI 0.52-0.83, P = 0.0004); the distant metastasis (DM) in long-term ADT group was lower than that in short-term treatment group (RR = 0.85, 95% CI 0.74-0.96, P = 0.01). Conclusion: The long-term ADT treatment is superior to the shortterm treatment in OS rate, DFS rate, DSS rate, LP rate, BF rate and DM rate after radiotherapy for moderate and high risk prostate cancer. Due to the limitation of the quantity and quality of the included literatures, the above conclusion need to be verified by higher quality research.