Efficiency and safety of androgen deprivation therapy combined with stereotactic body radiation therapy for localized prostate cancer: A Moroccan experience

Abstract

Purpose: This study aims to evaluate the efficacy and safety of combining androgen deprivation therapy (ADT) with stereotactic body radiation therapy (SBRT) in the treatment of localized prostate cancer.

Methods: A retrospective analysis was conducted on 30 patients treated with SBRT for localized prostate cancer at Cheikh Khalifa Hospital between 2017 and 2022. All patients presented with intermediate prognostic risk prostate cancer, as classified by the D'Amico criteria. Each patient received a total dose of 36.25Gy in five fractions using the TrueBeam STX system, along with six months of ADT. Patient outcomes were assessed based on relapse-free survival, biochemical recurrence, overall survival, and adverse effects, including gastrointestinal (GI) and genitourinary (GU) toxicities. Quality of life was evaluated using the EPIC-26 questionnaire.

Results: Over a median follow-up period of 33months, the relapse-free survival rate was 96.7%, with a biochemical recurrence rate of 3.3%. The overall survival rate at four years was 100%. Acute GI toxicities were minimal and transient, while GU toxicities were primarily grades 1 and 2, with no grade 3 or higher events reported. Erectile dysfunction was noted in 87% of patients. Quality of life assessments indicated low levels of urinary and bowel side effects but moderate impact on sexual function.

Conclusion: These findings suggest that the combination of ADT with SBRT approach offers favorable relapse-free and overall survival rates with manageable toxicity profiles. Further long-term studies are needed to confirm these results and better understand the impact on patient quality of life.

Keywords: Androgen deprivation therapy (ADT); Efficacy; Prostate cancer; Quality of life; Safety; Stereotactic body radiation therapy (SBRT).