Short‑term versus intermediate‑term androgen suppression plus radiotherapy with or without zoledronic acid in men with locally advanced prostate cancer: 10‑year results from the RADAR trial

Rákkutatás · Prostate cancer

A duration of 18 months of androgen suppression combined with radiotherapy reduces prostate‑cancer‑specific mortality compared with 6 months of androgen suppression, while the addition of zoledronic acid provides no survival benefit.

This phase‑3 randomised factorial trial (RADAR, NCT00193856) evaluated whether extending androgen suppression from 6 to 18 months and adding zoledronic acid improves outcomes in men with locally advanced prostate cancer receiving radiotherapy. Patients were allocated to short‑term androgen suppression (6 months) or intermediate‑term (18 months) with or without 18 months of zoledronic acid. Over a median follow‑up of 10.4 years, prostate‑cancer‑specific mortality fell from 13.7 % (6‑month group) to 9.8 % (18‑month group) (absolute difference 3.7 %, p=0.035). Zoledronic acid did not reduce mortality (11.7 % vs 11.7 %). The study confirms 18 months of androgen suppression plus radiotherapy is superior to 6 months, with no added benefit from zoledronic acid.

Extended androgen suppression improves survival in locally advanced prostate cancer without the need for additional bone‑protective therapy, refining treatment duration guidelines and avoiding unnecessary drug exposure.

Bizonyítékszint: Irányelv / elfogadott gyakorlat. Magas szintű klinikai elfogadottság.

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