Lawton CA, Winter K, Murray K, et al.
Abramson Cancer Center of the University of Pennsylvania
Reviewers: Li Liu, MD
Source: Int J Radiat Oncol Biol Phys 2001 Mar 15;49(4):937-46
In locally advanced prostate cancer, hormonal therapy often prolongs the suppression of the primary tumor when used with radiotherapy (RT). The question remains whether hormonal therapy should be reserved for relapse or used early in asymptomatic patients with locally advanced disease who are receiving external RT. In this phase III Radiation Therapy Oncology Group (RTOG) trial, the researchers compared the clinical outcome of patients who received RT only with those who had RT plus long-term adjuvant goserelin.
A total of 945 patients with locally advanced prostate cancer were included. Of these, 477 were randomized to the adjuvant hormone arm (Arm I) and 468 to the RT only arm (Arm II) with hormones reserved for radiation failures. Goserelin (Zoladex) was started during the last week of RT on Arm I and at the time of relapse on Arm II.
Adjuvant treatment with goserelin, when started simultaneously with external RT, improves local control and reduces distant metastasis in patients with locally advanced prostate cancer. For subgroup of patients with Gleason Score of 8-10, addition of goserelin improves overall survival as well.