Short-course androgen ablation combined with external-beam radiation therapy and low-dose-rate permanent brachytherapy in early-stage prostate cancer: A matched subset analysis

Background and Purpose: In order to evaluate the effect of short-term andro gen blockade on biochemical control rates for high-risk patients receiving a combination regimen of external-beam radiation therapy and low-dose-rate permanent seed implant brachytherapy, a retrospective matched subset analys is was performed. Patients and Methods: Inclusion in the high-risk cohort required at least t wo of the following poor prognostic factors: serum prostate specific antige n (PSA) concentration greater than or equal to 10.0 ng/mL, Gleason score gr eater than or equal to 7, or clinical stage T-2c or T-3a disease, Twenty-on e patients who underwent androgen ablation between June 1991 and December 1 995 in addition to combined-modality radiation therapy qualified as high ri sk, as did 77 patients who underwent combined-radiation therapy only. There was no statistically significant difference between the two groups in term s of follow-up (mean 44.6 v 47.8 months, respectively), pretreatment PSA, c linical stage, biopsy Gleason score, or the presence of all three poor prog nostic factors. Results: The overall rates of freedom from biochemical failure at 5 years w ere 77% in the hormonally treated group and 58% in the nonhormonally treate d group. The difference was not statistically significant by log rank test (P = 0.08), Conclusion: Longer follow-up with larger patient numbers is needed to defin e the role of adjuvant androgen ablation combined with radiation therapy.