Androgen Suppression With Salvage Radiotherapy May Fight Progression

Adding short-term androgen suppression to salvage radiotherapy may benefit men with prostate cancer who have undergone radical prostatectomy and whose prostate-specific antigen (PSA) level rises after a post-surgical period when it is undetectable, according to a French population study published in The Lancet Oncology.

In an open-label, multicenter, phase 3, randomized controlled trial, Christian Carrie, MD, of the Centre Léon Bérard in France, looked at 743 men who were randomly assigned to either standard salvage radiotherapy alone or radiotherapy plus short-term androgen suppression using 10.8 mg goserelin by subcutaneous injection on the first day of irradiation as well as 3 months later.

“We aimed to establish the effect of adding short-term androgen suppression at the time of salvage radiotherapy on biochemical outcome and overall survival in men with rising PSA following radical prostatectomy,” the authors said. Primary endpoint was progression-free survival, which they analyzed in the intent-to-treat population.

They found that patients who were assigned to radiotherapy plus goserelin were significantly more likely to be free of biochemical progression or clinical progression at 5 years than patients in the radiotherapy-alone group.

Additionally, they found no additional late adverse events in patients who received short-term androgen suppression compared to those who received radiotherapy alone. The most frequent acute adverse events related to goserelin were hot flushes, sweating, or both.
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“Radiotherapy combined with short-term androgen suppression could be considered as a reasonable option in this population,” the authors concluded.

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