Long-Term Outcomes of EBRT and Androgen Deprivation in Prostate Cancer

Barry Goy, MD, a radiation oncologist at Kaiser Permanente Los Angeles Medical Center, provides insight into the clinical implications of a retrospective analysis examining 15-year outcomes in patients with intermediate-risk prostate cancer (IRPC).

The study, which was presented at the 2025 Genitourinary Cancers Symposium, evaluated the effectiveness of external-beam radiation therapy (EBRT) with or without neoadjuvant androgen deprivation therapy (NADT) and its impact on long-term disease control.

According to findings from the trial, at a median follow-up of 12.0 years and a maximum of 19.8 years, the 15-year prostate cancer–specific survival rate was 91% for patients with IRPC undergoing short-term androgen deprivation (STAD) plus EBRT and those receiving EBRT alone (P = .67). The 15-year overall survival rate was 53% for those undergoing STAD plus EBRT and 51% for those undergoing EBRT alone (P = .82).

In this discussion, Goy explores how oncologists should interpret these findings and whether they should influence decision-making regarding the routine use of deprivation therapy. He highlights key considerations for patient counseling, balancing the potential benefits of hormonal therapy in improving PSA control with broader treatment goals, such as overall survival and quality of life.

Additionally, he addresses the nuances of patient understanding and decision-making, emphasizing the importance of individualized discussions based on cognitive and informational needs.

Transcription:

0:10 | Well, when I counsel patients, I basically tell them that the addition of 6 months of hormonal therapy will probably improve your PSA control rate. But our goal in treating prostate cancer, localized prostate cancer, is not necessarily just PSA outcomes.

0:31 | Probably the most important thing is, are they going to die of prostate cancer as a result of my intervention? So, counseling patients to understand that for some patients, it could be easy to grasp, and other patients may be difficult. So, it kind of depends on how cognitively, where the patient is, and how much they want to know.

REFERENCE:

Goy BW, Yao J. Fifteen-year outcomes of external radiation with or without 6 months of neoadjuvant deprivation therapy for intermediate risk prostate cancer. J Clin Oncol. 2025;43(suppl 5):388. doi:10.1200/JCO.2025.43.5_suppl.388