Androgen-deprivation therapy alone versus combined with radiation therapy or chemotherapy For nonlocalized prostate cancer： a systematic review and meta-analysis

作     者：Jun-Hao Lei Liang-Ren Liu Qiang Wei Tu-Run Song Lu Yang Yang Meng Ping Han 

作者机构：Department of Urology West China Hospital Sichuan University Guoxue Xiang #37 Chengdu 610041 Sichuan China 

出 版 物：《Asian Journal of Andrology》 (亚洲男性学杂志（英文版）)

年 卷 期：2016年第18卷第1期

页      面：102-107页

核心收录：

学科分类：0710[理学-生物学] 1002[医学-临床医学] 07[理学] 08[工学] 071007[理学-遗传学] 0812[工学-计算机科学与技术（可授工学、理学学位）] 081202[工学-计算机软件与理论] 

基　　金：ACKNOWLEDGM ENTS This research was funded by the National Natural Science Foundation of China （grant No. 81200551 81370855 81270841 30901484 81300627）. 

主　　题：androgen-deprivation chemotherapy prostate cancer quality-of-life radiation therapy 

摘      要：In this paper, we reviewed the long-term survival outcomes, safety, and quality-of-life of androgen-deprivation therapy （ADT） alone versus combined with radiation therapy （RT） or chemotherapy for locally advanced and metastatic prostate cancer （PCa）. A literature search was performed using OvidSP. Randomized controlled trials （RCTs） that met the following criteria were included： including locally advanced or metastatic PCa, comparing ADT alone versus combined with any treatment method and reporting quantitative data of disease control or survival outcomes. Finally, eight RCTs met the inclusion criteria. Among these, three compared ADT versus ADT plus RT （n = 2344） and one compared ADT versus ADT plus docetaxel-estramustine （n = 413） in locally advanced PCa; two compared ADT versus ADT plus docetaxel （n = 1175） and two compared ADT versus ADT plus estramustine （n = 114） in metastatic PCa. For locally advanced PCa, the addition of RT to long-term ADT can improve the outcomes of survival and tumor control with fully acceptable adverse effects. Specially, the pooled odds ratio （OR） of overall survival （OS） was 1.43 （95% confidence interval 1.20-1.71） when compared ADT plus RT with ADT alone （P 〈 0.0001）. For metastatic hormonally sensitive PCa, the concurrent use of docetaxel plus ADT was effective and safe （pooled OR of OS： 1.29 [1.01-1.65]： P = 0.04）. In all, long-term ADT plus RT and long-term ADT plus docetaxel should be considered as proper treatment option in locally advanced and metastatic hormonally sensitive PCa, respectively. The major limitation for the paper was that only eight RCTs were available.