Radiotherapy Plus GnRH Analogue Versus High Dose Bicalutamide: A Case Control Study

Anticancer Res. 2019 Nov;39(11):6373-6378. doi: 10.21873/anticanres.13850.

Abstract

Background/aim: Radiotherapy (RT) with adjuvant hormone therapy (HT) improves prognosis in prostate cancer (PC) patients. Gonadotrophin-releasing hormone agonist (GnRHa) with luteinizing hormone-releasing hormone (LH-RH) analogues is the standard HT. High-dose antiandrogen therapy also improves survival in patients with locally advanced PC. The aim of this study was to compare the results of patients treated with RT plus GnRHa and patients treated with RT plus bicalutamide.

Patients and methods: Our institutional PC database was used to identify patients treated with definitive or postoperative RT +/- HT which were included in this study.

Results: Three hundred and eighteen patients were retrospectively reviewed (median follow-up=56 months). Five-year biochemical relapse-free survival was 85.5% and 88.3% in patients treated with GnRHa and bicalutamide, respectively (p=0.712).

Conclusion: Bicalutamide may be offered as an adjuvant treatment to RT in patients who refuse GnRHa because of related side effects. Furthermore, our study justifies randomized trials comparing RT plus GnRHa and RT plus bicalutamide.

Keywords: Prostate neoplasm; adjuvant hormonal therapy; bicalutamide; gonadotrophin-releasing hormone agonist; radiotherapy.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Androgen Antagonists / administration & dosage*
  • Androgen Antagonists / adverse effects
  • Anilides / administration & dosage*
  • Anilides / adverse effects
  • Antineoplastic Agents, Hormonal / administration & dosage*
  • Antineoplastic Agents, Hormonal / adverse effects
  • Case-Control Studies
  • Combined Modality Therapy / methods
  • Gonadotropin-Releasing Hormone / agonists*
  • Humans
  • Male
  • Middle Aged
  • Nitriles / administration & dosage*
  • Nitriles / adverse effects
  • Prognosis
  • Prostate-Specific Antigen / blood
  • Prostatic Neoplasms / drug therapy*
  • Prostatic Neoplasms / radiotherapy*
  • Retrospective Studies
  • Tosyl Compounds / administration & dosage*
  • Tosyl Compounds / adverse effects

Substances

  • Androgen Antagonists
  • Anilides
  • Antineoplastic Agents, Hormonal
  • Nitriles
  • Tosyl Compounds
  • Gonadotropin-Releasing Hormone
  • bicalutamide
  • Prostate-Specific Antigen