Short-term versus long-term hormone therapy plus radiotherapy or prostatectomy for prostate cancer: a systematic review and meta-analysis

  • Zhi-Rui Zhou
  • Xiao-Dong Zhu
  • Jun Xia
  • Zhang-Yu Zou
  • Song Qu
  • Xian-Tao Zeng
  • Zhi Mao
  • Zhong-Guo Liang
Original Paper

DOI: 10.1007/s00432-013-1383-7

Cite this article as:
Zhou, ZR., Zhu, XD., Xia, J. et al. J Cancer Res Clin Oncol (2013) 139: 783. doi:10.1007/s00432-013-1383-7

Abstract

Purpose

To compare the efficacy and safety of short-term versus long-term hormonotherapy (HT) plus radiotherapy (RT) or prostatectomy (RP) for prostate cancer.

Methods

Literatures were searched from Embase, PubMed, Web of science and Cochrane Library up to October, 2012. Quality of the study was evaluated according to the Cochrane’s risk of bias of randomized controlled trial (RCT); the Grading of Recommendations Assessment, Development and Evaluation System was used to rate the level of evidence. RevMan 5.1 was used for statistical analysis. Two comparisons were of interest: RT plus short-term HT versus RT plus long-term HT and RP plus short-term HT versus RP plus long-term HT. Pooled risk ratio or standardized mean differences were calculated; HT adverse reactions were descriptively evaluated.

Results

Nine RCTs (total 4,743 patients) were included, 7 RCTs compared RT plus short-term HT with RT plus long-term HT, 2 RCTs compared RP plus short-term HT with RP plus long-term HT. Meta-analysis showed there was no significant difference in overall survival, disease-free survival and PSA level before RP; long-term was superior to short-term hormonotherapy in biochemical failure rate, clinical progression rate, prostate cancer-specific mortality, positive surgical margin rate and prostate volume before RP. Systematic review demonstrated adverse events caused by the increased length of HT were more common.

Conclusions

Long-term HT plus RT showed a trend toward improved overall survival; long-term HT plus RP declined positive surgical margin rate and prostate volume before RP. So, long-term HT may benefit more, but it did not significantly improve the patients’ overall survival, and the adverse reactions are inevitable.

Keywords

Prostatic cancer Radical prostatectomy Radiotherapy Hormone therapy Meta-analysis 

Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Zhi-Rui Zhou
    • 1
  • Xiao-Dong Zhu
    • 1
  • Jun Xia
    • 2
  • Zhang-Yu Zou
    • 3
  • Song Qu
    • 1
  • Xian-Tao Zeng
    • 4
  • Zhi Mao
    • 5
  • Zhong-Guo Liang
    • 1
  1. 1.Department of Radiation Oncology, Cancer Hospital of Guangxi Medical UniversityCancer Institute of Guangxi Zhuang Autonomous RegionNanningPeople’s Republic of China
  2. 2.Cochrane Schizophrenia GroupThe University of NottinghamNottinghamUK
  3. 3.Department of Neurology of Peking Union Medical College HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingPeople’s Republic of China
  4. 4.Department of Stomatology, Taihe HospitalHubei University of MedicineShiyanPeople’s Republic of China
  5. 5.Department of OrthopaedicsChinese PLA General HospitalBeijingPeople’s Republic of China

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