prac.co/l/yexsvfxz (Practice Update paper, "ASTRO 2021: In HDRT for Localized Prostate Cancer, Long-Term Androgen Deprivation Fails to Compare Favorably to the Short-Term Alternative"
The footnote to the title is: "Lack of statistical significance may be due to shortcomings of the trial."
The conclusion seems to be that long-term ADT (24 months) is not superior to short-term ADT (4 months) when combined with high-dose RT. Problem I see is the results they give don't seem to show this. In each case, unless I'm misreading the results, the long term ADT treatment seems to give a 4-6% improvement in the outcome.
Am I misunderstanding this - or is it just a silly paper?
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Don_1213
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Not sure what your interest is, since you seem to have been successfully treated. The only part that's relevant for you is: "The subgroup of patients with high-risk prostate cancer treated with long-term androgen deprivation experienced a non[statistically] significant improvement in biochemical disease - free, metastasis-free, and overall survival vs short-term androgen deprivation. The relatively small sample size, low number of events, and effective salvage treatment could explain the lack of statistical significance."
I have an interest in a lot of PCa things.. in this case how a paper with obviously contrary results to the conclusion/title even manage to get published. While I may have been successfully treated - the realist in me knows that any "cure" of PCa is basically remission, in some cases long-term (my hope..) And often long enough remission that something else gets you before the PCa reappears.
Assuming they intended the order to be the same for the two results and the name (long and short term) of the results:
Ten-year biochemical disease - free survival with long- and short-term androgen deprivation was, respectively, 67.2% and 53.7% (log rank P = .03, Fine & Gray regression P = .147, hazard ratio 1.12 95% confidence interval 0.61 to 2.04).
It appears that a 13.5% improvement in 10 year biochemical free survival was "insignificant"? That's what I don't understand - all the results are similar to this one (not quite as extreme) so how did they come up with the conclusion shown in the title.
They are saying the LT vs ST ADT 13.5% "improvement" in bDFS is a statistically insignificant difference. So LT ADT failed to compare favorably to STADT. That is consistent.
Looks like you read it right. Just that they don't consider 5-7 % longer life significant where you and I might think a 5-7% chance of longer life really matters. Life is Good, longer life may be better..
We all would like to escape adt in four months . But I’ve been on it six years . No one says stop it .. some have been on adt for decades . There is nothing we like about it ,except it keeping the Psa down and not feeding the pc .
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