KEY POINTS
- SPPORT randomized men with detectable prostate-specific antigen after prostatectomy to prostate-bed radiotherapy alone, prostate-bed radiotherapy plus 4–6 months of androgen deprivation, or pelvic-node and prostate-bed radiotherapy plus androgen deprivation.
- The quality-of-life cohort included 644 patients, assessed at baseline, treatment week six, and one and five years after radiotherapy.
- Bowel and urinary scores declined during treatment and subsequently improved, although average scores remained below baseline at five years.
- Sexual and hormonal quality of life was worse with androgen deprivation at six weeks and one year, but no clinically significant treatment-arm differences remained at five years.
- Quality-adjusted freedom-from-progression was 5.5, 6.2 and 6.6 years across the three respective arms, favouring both androgen-deprivation-containing strategies over prostate-bed radiotherapy alone.
CLINICAL TAKEAWAY
The progression benefit of adding short-term androgen deprivation, with or without pelvic-node treatment, was not accompanied by a clinically meaningful long-term quality-of-life penalty. Patients should still be counselled about substantial early sexual and hormonal effects and incomplete recovery of some urinary and bowel domains.
SOURCE
International Journal of Radiation Oncology, Biology, Physics