Jiang T, Markovic D, Patel J, et al. - This meta-analysis implies that adding androgen deprivation therapy (ADT), vs increasing radiation therapy (RT) dose alone, offers a more consistent improvement in clinical endpoints, while limited by between-study heterogeneity and a lack of individual patient data.

• Researchers conducted a meta-regression of 40 individual trials with 21,429 total patients to allow a comparison of the rates and cumulative proportions of 5-year overall survival, prostate cancer-specific mortality (PCSM), and distant metastasis for each treatment arm of every trial.

• It was shown that dose-escalation either in the absence or presence of short-term ADT (STADT) failed to significantly improve any 5-year outcome.

• The results showed that adding LTADT to low dose RT significantly improved 5-year PCSM (Odds ratio [OR] 0.34, 95% confidence interval [CI] 0.22–0.54, p < 0.001) and DM (OR 0.35, 95% CI 0.20–0.63. p < 0.001) over low dose RT alone.

• Five-year PCSM was also significantly improved by adding STADT over low dose RT alone (OR 0.55, 95% CI 0.41–0.75, p < 0.001).