ABSTRACT

To determine whether intermittent androgen deprivation therapy would provide the cancer control and survival benefit as continuous androgen deprivation therapy in patients with metastatic prostate cancer. Androgen deprivation therapy is the first-line treatment in advanced stage or metastatic prostate cancer. Androjen deprivation therapy with radiation can be given in high risk localized prostate cancer. Hormonal changes caused by this treatment will lead to both short and long-term adverse effects. Although some of these adverse effects are treatable, they significantly decrease the tolerance to the treatment and may even cause discontinuation of the treatment. Intermittent hormonal therapies have recently become popular in order to avoid adverse effects during cancer treatment. In this review article, we presented the advantages and disadvantages of continuous and intermittent androgen deprivation therapies. Many studies that assess both treatment strategies have shown that intermittent therapy may be a good option for patients who are asymptomatic, well-motivated patients with metastatic disease, patients who showed relapse after radiation therapy and patients who show major PSA response after initial induction treatment. Data about whether intermittent androgen deprivation therapy increases cancer-specific survival are still insufficient. Although increase in quality of life is similar in both treatment arms, higher sexual activity scores and less hot flashes in the intermittent androgen deprivation therapy arm seem to be an advantage. Still, the best candidates for intermittent androgen deprivation therapy are patients who relapsed after prostatectomy or radiation therapy without systemic metastases and patients with mildly aggressive tumors.