New evidence in neoplastic and cardiovascular medicine.

The researchers of the European Organization for Research and Treatment of Cancer (EORTC), Radiation Oncology Group and Genito-Urinary Tract Cancer Group conducted a trial to investigate if brief-term androgen suppression (radiotherapy and 6 months of androgen suppression) could maintain quality of life and obtain the general survival rate achieved with long-term androgen suppression (radiotherapy and 3 years of androgen suppression) in individuals with locally advanced prostate cancer. Almost 1,000 subjects (970) who had had external-beam radiotherapy and 6 months of androgen suppression were allocated in a random way to two groups, one receiving no other treatment (brief-term suppression, 483 patients) and the other receiving further treatment with a luteinizing hormone-releasing hormone agonist for 2.5 years (longterm suppression, 487 patients). Ninety-eight patients in the long-term group and 132 patients in the brief-term suppression group were died after a follow-up period of 6.4 years, and 29 were died because of prostate cancer in the long-term suppression group, compared to 47 in the brief-term group. The general mortality at 5 years for the long-term suppression group was 15.2%, compared to an overall mortality of 19% in the brief-term suppression group, with an observed hazard ratio of 1.42. Statistically significant differences were documented between the groups with reference to insomnia (P = 0.006), hot flushes (P \ 0.001) and sexual activity (P \ 0.001). The authors conclude that in patients with locally advanced prostate tumour radiotherapy and 3 years of androgen suppression achieve higher survival if compared with radiotherapy and 6 months of androgen suppression.