Combined androgen blockade (CAB) versus luteinizing hormone-releasing hormone (LHRH) agonist monotherapy for androgen deprivation therapy
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Combined androgen blockade (CAB) and luteinizing hormone-releasing hormone (LHRH) agonist monotherapy are commonly used in androgen deprivation therapy (ADT). In this randomized clinical trial, we aimed to compare the two methods of ADT in terms of quality of life (QOL).
Eighty patients who underwent primary ADT for newly diagnosed prostate cancer were randomly assigned to CAB group (Group 1) and LHRH agonist monotherapy group (Group 2). Leuprolide and anti-androgen (bicalutamide 50 mg) were used to minimize the confounding effects caused by medication. QOL was evaluated at baseline, 3 months and 6 months post-ADT using validated EORTC QLQ-C30, PR25, and depression questionnaires. A difference of > 10 points in the EORTC domain scores was defined as ‘clinically significant’.
In the baseline characteristics, there was no significant difference between the two groups. At 3 months after ADT, Group 1 had significantly lower pain scores than Group 2 (p = 0.004), while Group 1 had significantly poorer diarrhea symptom score than Group 2, without clinical significance (p = 0.047). No significant differences were observed in the C30, PR25 domains, and the depression score at 3 months. At 6 months, the QOL scores of all the groups were similar.
There was no difference in the patient’s QOL, except that CAB group was associated with significantly better pain relief than LHRH agonist monotherapy at 3 months following ADT, which was not sustained thereafter. Our results suggest that the benefit of prolonged (≥ 3 months) CAB is questionable in terms of patients’ QOL.
KeywordsProstate cancer Androgen deprivation therapy Combined androgen blockade Luteinizing hormone-releasing hormone agonist Quality of life
This study was supported by DAEWOONG Pharm, Co. Research Grant.
HSP data analysis, manuscript writing/editing. HBS data analysis, manuscript writing/editing. SHW data collection. SHJ data collection. SHL data collection. SHK data collection. JSS data collection. DWS data collection, data analysis. JP project development, data collection, data analysis, manuscript writing/editing.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interests.
All procedures performed in this study were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The study was approved by the Institutional Review Board of the Eulji University Hospital (No. 2014-03-011).
A written informed consent was obtained from each patient before screening.
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