Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Clinical Trial
. 2017 Jun 1;98(2):296-303.
doi: 10.1016/j.ijrobp.2017.02.004. Epub 2017 Feb 12.

Duration of Androgen Deprivation in Locally Advanced Prostate Cancer: Long-Term Update of NRG Oncology RTOG 9202

Colleen A F Lawton  1 , Xiaolei Lin  2 , Gerald E Hanks  3 , Herbert Lepor  4 , David J Grignon  5 , Harmar D Brereton  6 , Meena Bedi  7 , Seth A Rosenthal  8 , Kenneth L Zeitzer  9 , Varagur M Venkatesan  10 , Eric M Horwitz  3 , Thomas M Pisansky  11 , Harold Kim  12 , Matthew B Parliament  13 , Rachel Rabinovitch  14 , Mack Roach 3rd  15 , Young Kwok  16 , James J Dignam  17 , Howard M Sandler  18
Affiliations
Clinical Trial

Duration of Androgen Deprivation in Locally Advanced Prostate Cancer: Long-Term Update of NRG Oncology RTOG 9202

Colleen A F Lawton et al. Int J Radiat Oncol Biol Phys. .

Abstract

Purpose: Trial RTOG 9202 was a phase 3 randomized trial designed to determine the optimal duration of androgen deprivation therapy (ADT) when combined with definitive radiation therapy (RT) in the treatment of locally advanced nonmetastatic adenocarcinoma of the prostate. Long-term follow-up results of this study now available are relevant to the management of this disease.

Methods and materials: Men (N=1554) with adenocarcinoma of the prostate (cT2c-T4, N0-Nx) with a prostate-specific antigen (PSA) <150 ng/mL and no evidence of distant metastasis were randomized (June 1992 to April 1995) to short-term ADT (STAD: 4 months of flutamide 250 mg 3 times per day and goserelin 3.6 mg per month) and definitive RT versus long-term ADT (LTAD: STAD with definitive RT plus an additional 24 months of monthly goserelin).

Results: Among 1520 protocol-eligible and evaluable patients, the median follow-up time for this analysis was 19.6 years. In analysis adjusted for prognostic covariates, LTAD improved disease-free survival (29% relative reduction in failure rate, P<.0001), local progression (46% relative reduction, P=.02), distant metastases (36% relative reduction, P<.0001), disease-specific survival (30% relative reduction, P=.003), and overall survival (12% relative reduction, P=.03). Other-cause mortality (non-prostate cancer) did not differ (5% relative reduction, P=.48).

Conclusions: LTAD and RT is superior to STAD and RT for the treatment of locally advanced nonmetastatic adenocarcinoma of the prostate and should be considered the standard of care.

PubMed Disclaimer

Conflict of interest statement

Conflicts of interest: Dr. Sandler reports grants from ACR-RTOG, during the conduct of the study; consulting fees from Sanofi, Medivation, Clovis Oncology, Janssen, Ferring, and Blue Earth Diagnostics, speaking fees from Varian outside the submitted work.

Figures

Figure 1
Figure 1
Disease-free survival (A), distant metastasis (B), death from prostate cancer (C), and overall survival (death from any cause) (D) by treatment group. Plots in panels A and D are Kaplan-Meier curves; plots in panels B and C are (1 – cumulative incidence estimator). P-values are from unadjusted logrank tests. See Table 2 for adjusted hazard ratios and p-values.
Figure 2
Figure 2
Disease-free survival (A), distant metastasis (B), death from prostate cancer (C), and overall survival (death from any cause) (D) by treatment group for patients with Gleason score 8- 10 and N0/NX nodal status. Plots in panels A and D are Kaplan-Meier curves; plots in panels B and C are (1 – cumulative incidence estimator). P-values are from unadjusted logrank tests. See Table 3 for adjusted hazard ratios and p-values.
Figure 3
Figure 3
Cumulative incidence of grade 3 or greater genitourinary (GU) late toxicity (A) and gastrointestinal (GI) late toxicity (B). P-value is from Gray’s test.
See this image and copyright information in PMC

Comment in

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. ****

    1. Pilepich MV, Winter K, John MJ, et al. Phase III radiation therapy oncology group (RTOG) trial 8610 of androgen deprivation adjuvant to definitive radiotherapy in locally advanced carcinoma of the prostate. Int J Rad Onc Biol & Phys. 2001;50:1243–1252. - PubMed
    1. Bolla M, Collette L, Blank L, et al. Long term results with immediate androgen suppression and external irradiation in patients with locally advanced prostate cancer (an EORTC study): A phase III randomized trial. Lancet. 2002;360:103–106. - PubMed
    1. Bolla M, de Reijke T, Van Tienhoven G, et al. Duration of androgen suppression in the treatment of prostate cancer. New Eng Jour of Med. 2009;360(24):2516–2027. - PubMed

    1. ****

Publication types

MeSH terms