Abstract
Context
Objective
Evidence acquisition
Evidence synthesis
Conclusions
Keywords
1. Introduction
Heidenreich A, Bolla M, Joniau S, et al. Guidelines on prostate cancer. Arnhem, Netherlands: European Association of Urology; 2009. http://www.uroweb.org/fileadmin/tx_eauguidelines/2009/Full/Prostate_Cancer.pdf. Accessed May 2009.
Heidenreich A, Bolla M, Joniau S, et al. Guidelines on prostate cancer. Arnhem, Netherlands: European Association of Urology; 2009. http://www.uroweb.org/fileadmin/tx_eauguidelines/2009/Full/Prostate_Cancer.pdf. Accessed May 2009.
Heidenreich A, Bolla M, Joniau S, et al. Guidelines on prostate cancer. Arnhem, Netherlands: European Association of Urology; 2009. http://www.uroweb.org/fileadmin/tx_eauguidelines/2009/Full/Prostate_Cancer.pdf. Accessed May 2009.
2. Evidence acquisition
3. Evidence synthesis
3.1 What is the added value of neoadjuvant or adjuvant hormone therapy with radical prostatectomy?
3.2 What is the added value of neoadjuvant or adjuvant hormone therapy with radiotherapy?
- Jones S.O.
- Alexander A.
- Crook J.
- Lesperance M.
- Ludgate C.
3.3 What is the optimal duration of neoadjuvant or adjuvant hormone therapy with radiotherapy?
- Bolla M.
- De Reijke Th.M.
- Van Tienhoven G.J.
- et al.


3.4 Continuous or intermittent hormone therapy in advanced prostate cancer?
Trials | Study population | No. of patients randomised | Final/preliminary data |
---|---|---|---|
SWOG 9346 [31] | M+ PCa (PSA ≥5 ng/ml) | 1345 | PSA normalisation rates (open) |
SEUG 9401 [32] | Locally advanced or M+ PCa | 626 | No difference in overall survival and time to progression between intermittent and continuous HT. |
Intermittent HT is associated with fewer adverse events and better sexual activity than continuous HT (closed). | |||
Europe [33] | Locally advanced or M+ PCa | 914 | Intermittent HT is associated with better sexual activity and fewer adverse events than continuous HT (open). |
EC507 [34] | PSA relapse after RP | 201 | No difference in time to progression between intermittent and continuous HT. |
Intermittent HT is associated with an improved quality of life and lower incidence of adverse events than continuous HT (closed). |

Heidenreich A, Bolla M, Joniau S, et al. Guidelines on prostate cancer. Arnhem, Netherlands: European Association of Urology; 2009. http://www.uroweb.org/fileadmin/tx_eauguidelines/2009/Full/Prostate_Cancer.pdf. Accessed May 2009.
3.5 Quality of life of prostate cancer patients on hormone therapy: Do we care enough?
Heidenreich A, Bolla M, Joniau S, et al. Guidelines on prostate cancer. Arnhem, Netherlands: European Association of Urology; 2009. http://www.uroweb.org/fileadmin/tx_eauguidelines/2009/Full/Prostate_Cancer.pdf. Accessed May 2009.

4. Conclusions
Conflicts of interest
Funding support
Acknowledgements
References
- Estimates of the cancer incidence and mortality in Europe in 2006.Ann Oncol. 2007; 18: 581-592
- Patterns and trends in prostate cancer incidence, survival, prevalence and mortality. Part II: individual countries.BJU Int. 2002; 90: 174-184
Heidenreich A, Bolla M, Joniau S, et al. Guidelines on prostate cancer. Arnhem, Netherlands: European Association of Urology; 2009. http://www.uroweb.org/fileadmin/tx_eauguidelines/2009/Full/Prostate_Cancer.pdf. Accessed May 2009.
- Studies on prostatic cancer. I. The effect of castration, of estrogen and of androgen injection on serum phosphatases in metastatic carcinoma of the prostate.Cancer Res. 1941; 1: 293-297
- Optimizing outcomes and quality of life in the hormonal treatment of prostate cancer.BJU Int. 2006; 98: 20-27
- Side effects of androgen deprivation therapy: monitoring and minimizing toxicity.Urology. 2003; 61: 32-38
- A systematic review and meta-analysis of randomised trials of neo-adjuvant hormone therapy for localised and locally advanced prostate carcinoma.Cancer Treat Rev. 2009; 35: 9-17
- Use of up-front androgen deprivation therapy with salvage radiation in the post-prostatectomy setting may improve biochemical outcomes.Int J Radiat Oncol Biol Phys. 2008; 72 (abstract 2313): S309
- Timing of androgen deprivation therapy and its impact on survival after radical prostatectomy: a matched cohort study.J Urol. 2008; 179: 1830-1837
- Nomogram predicting the probability of early recurrence after radical prostatectomy for prostate cancer.J Urol. 2009; 181: 601-608
- Improved survival in patients with locally advanced prostate cancer treated with radiotherapy and goserelin.N Engl J Med. 1997; 337: 295-300
- Ten year results of long term adjuvant androgen deprivation with goserelin in patients with locally advanced prostate cancer treated with radiotherapy: a phase III EORTC study.Int J Radiat Oncol Biol Phys. 2008; 72 (abstract 65): S30-S31
- Endocrine treatment, with or without radiotherapy, in locally advanced prostate cancer (SPCG-7/SFUO-3): an open randomised phase III trial.Lancet. 2009; 373: 301-308
- Androgen suppression and radiation vs radiation alone for prostate cancer: a randomized trial.JAMA. 2008; 299: 289-295
- Intermediate-risk prostate cancer and dose escalated radiation therapy: selection of patients for androgen deprivation therapy using percent positive cores.Int J Radiat Oncol Biol Phys. 2008; 72 (abstract 2269): S89-90
- Radiation therapy for high risk prostate cancer: do patients 70 years or older benefit from combined androgen deprivation therapy?.Int J Radiat Oncol Biol Phys. 2008; 72 (abstract 166): S75-S76
- PSA “halving-time” during neoadjuvant androgen deprivation therapy and prior to radiotherapy is associated with biochemical control.Int J Radiat Oncol Biol Phys. 2008; 72 (abstract 122): S56
- Biochemical response is more critical than total duration of neo-adjuvant hormone therapy (NAHT) prior to radiotherapy for localized prostate cancer: analysis of the 3 vs 8 month data.Int J Radiat Oncol Biol Phys. 2008; 72 (abstract 163): S74
- Short-term neoadjuvant androgen deprivation therapy and external-beam radiotherapy for locally advanced prostate cancer: long-term results of RTOG 8610.J Clin Oncol. 2008; 26: 585-591
- Final report of a Canadian phase III trial of 3 vs. 8 months neoadjuvant androgen deprivation prior to 66 Gray external beam radiotherapy for clinically localized prostate cancer.Int J Radiat Oncol Biol Phys. 2008; 72 (abstract 165): S75
- Six-month concomitant and adjuvant hormonal treatment with external beam irradiation is inferior to 3-years hormonal treatment for locally advanced prostate cancer: results of the EORTC randomised phase III trial 22961.Eur Urol Suppl. 2008; 7 (abstract 186): 117
- Ten-year follow-up of radiation therapy oncology group protocol 92-02: a phase III trial of the duration of elective androgen deprivation in locally advanced prostate cancer.J Clin Oncol. 2008; 26: 2497-2504
- Diabetes and cardiovascular disease during androgen deprivation therapy for prostate cancer.J Clin Oncol. 2006; 24: 4448-4456
- Androgen deprivation therapy increases cardiovascular morbidity in men with prostate cancer.Cancer. 2007; 110: 1493-1500
- Testosterone recovery after prolonged androgen suppression in patients with prostate cancer.J Urol. 2008; 180: 1438-1443
- The current status of intermittent androgen deprivation (IAD) therapy for prostate cancer: putting IAD under the spotlight.BJU Int. 2007; 99: 19-22
- The continued debate: Intermittent vs. continuous hormonal ablation for metastatic prostate cancer.Urol Oncol. 2009; 27: 81-86
- Can intermittent hormone therapy fulfil its promise?.Eur Urol Suppl. 2008; 7: 752-757
- The role of intermittent androgen deprivation in prostate cancer.BJU Int. 2007; 100: 738-743
- International study into the use of intermittent hormone therapy in the treatment of carcinoma of the prostate: a meta-analysis of 1446 patients.BJU Int. 2007; 99: 1056-1065
- Absolute prostate-specific antigen value after androgen deprivation is a strong independent predictor of survival in new metastatic prostate cancer: data from Southwest Oncology Group Trial 9346 (INT-0162).J Clin Oncol. 2006; 24: 3984-3990
- Intermittent androgen deprivation for locally advanced and metastatic prostate cancer: results from a randomised phase 3 study of the South European Uroncological Group.Eur Urol. 2009; 55: 1269-1277
- Evaluation of quality of life, side effects and duration of therapy in a phase 3 study of intermittent monotherapy versus continuous combined androgen deprivation.Eur Urol Suppl. 2008; 7 (abstract 540): 205
- Intermittent androgen deprivation in patients with PSA-relapse after radical prostatectomy—final results of a European randomized prospective phase-III clinical trial AUO study AP 06/95, EC 507.J Urol. 2007; 177 (abstract 600): 201
- Promoting general health during androgen deprivation therapy (ADT): a rapid 10-step review for your patients.Urol Oncol. 2005; 23: 56-64
- Toremifene increases bone mineral density in men receiving androgen deprivation therapy for prostate cancer: interim analysis of a multicenter phase 3 clinical study.J Urol. 2008; 179: 152-155
- Toremifene improves lipid profiles in men receiving androgen-deprivation therapy for prostate cancer: interim analysis of a multicenter phase III study.J Clin Oncol. 2008; 26: 1824-1829
- The European patient of the future (state of health).Open University Press, Maidenhead, UK2003
- Counselling the prostate cancer patient.Eur Urol Suppl. 2008; 7: 765-771
- Assessing the attitudes to prostate cancer treatment among European male patients.BJU Int. 2007; 100: 6-11