Androgen-deprivation therapy in prostate cancer: A European expert panel review

Claude C. Schulman, Jacques Irani, Juan Morote, Jack A. Schalken, Francesco Montorsi, Piotr L. Chlosta, Axel Heidenreich

Research output: Contribution to journalArticlepeer-review

Abstract

Context: Androgen-deprivation therapy (ADT) is the mainstay of treatment for metastatic prostate cancer and is also recommended in association with external-beam radiation therapy (EBRT) for patients with high-risk disease. Objective: Our aim was to make recommendations regarding optimal timing of ADT, target serum testosterone levels, intermittent ADT delivery, and quality of life (QoL) during ADT. Evidence acquisition: This review contains recommendations from a European expert panel held in May 2009. Evidence synthesis: There is ongoing debate over whether ADT should be initiated at diagnosis or delayed until biochemical or symptomatic progression. Immediate ADT is recommended for metastatic disease to defer symptom development and reduce serious complications. In node-positive disease or high-risk nonmetastatic disease unfit for curative therapy, immediate ADT is also an option. Furthermore, there is a clear benefit of adjuvant ADT in association with EBRT in patients with high-risk disease. Some retrospective evidence also supports adjuvant ADT use following radical prostatectomy for high-risk localised disease. In cases of biochemical relapse after definitive local therapy, early ADT may benefit patients with poor prognostic factors. For patients on ADT, the traditional

Original languageEnglish
Pages (from-to)675-691
Number of pages17
JournalEuropean Urology, Supplements
Volume9
Issue number7
DOIs
Publication statusPublished - Oct 2010

Keywords

  • Androgen-deprivation therapy
  • Hormonal therapy
  • Intermittent therapy
  • Luteinising hormone-releasing hormone agonist
  • Prostate cancer
  • Quality of life

ASJC Scopus subject areas

  • Urology

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