Not sure I understand the conclusions..

[Don_1213]

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?

[Tall_Allen]

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."

[Don_1213 in reply to Tall_Allen]

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.

[Tall_Allen in reply to Don_1213]

Not sure what you you see as "contrary results." It looks fine to me.

[Don_1213 in reply to Tall_Allen]

Allen,

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.

[Tall_Allen in reply to Don_1213]

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.

[Shooter1]

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..

[Hidden]

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 .

[j-o-h-n]

Don....................... It's very much like the following conclusion about Don Juan's sex life......"With just Juan.... he was Don"............

Good Luck, Good Health and Good Humor.

j-o-h-n Saturday 11/06/2021 11:38 PM DST