{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T22:06:31Z","timestamp":1791410791708,"version":"4.3.3"},"reference-count":29,"publisher":"American Medical Association (AMA)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Oncol"],"published-print":{"date-parts":[[2026,1,1]]},"abstract":"\n Importance<\/jats:title>\n The ideal duration of androgen deprivation therapy (ADT) for treating localized prostate cancer is unknown due to variable adherence and treatment durations tested in clinical trials.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To determine the ideal duration of ADT for patients with prostate cancer treated with radiotherapy.<\/jats:p>\n <\/jats:sec>\n \n Data Sources<\/jats:title>\n This individual patient data meta-analysis of 13 randomized phase 3 clinical trials evaluated the use of radiotherapy alone or with ADT. It included patients with a median follow-up of 11.3 (IQR, 9.5-14.5) years and ADT duration of 0 to 36 months. Most patients (7392 [72%]) included had National Comprehensive Cancer Network high-risk or very high-risk disease.<\/jats:p>\n <\/jats:sec>\n \n Study Selection<\/jats:title>\n For this meta-analysis, a systematic literature search from 1980 to 2020 was performed in trial registries (Cochrane Central Register of Controlled Trials and ClinicalTrials.gov), MEDLINE (1966-2020), Embase (1982-2020), Web of Science, and Scopus to identify trials.<\/jats:p>\n <\/jats:sec>\n \n Data Extraction and Synthesis<\/jats:title>\n Intention-to-treat and as-treated analyses were performed. The number needed to treat to prevent 1 distant metastasis at 10 years was calculated based on prognostic risk group. The analyses were conducted from January 5 to August 15, 2023.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n The primary end point for this study was overall survival, defined as time to death or last follow-up from randomization. Secondary end points included biochemical recurrence, distant metastasis (DM), prostate cancer\u2013specific mortality, and other-cause mortality.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n The median (IQR) age among the 10\u202f266 male patients was 70 (65-74) years. Longer durations of ADT were associated with nonlinear improvement in relative benefits of DM, prostate cancer\u2013specific mortality, and overall survival, with reduced estimated benefits beyond 9 to 12 months of ADT based on the end point. There was a near-linear increase in other-cause mortality associated with long-term ADT use (hazard ratio, 1.28; 95% CI, 1.09-1.50;\n P<\/jats:italic>\n \u2009=\u2009.002 for 28 vs 0 months of ADT). The optimal ADT duration based on 10-year DM was 0, 6, 12 months, and undefined for patients with 1 intermediate-risk factor, 2 or more intermediate-risk factors, and National Comprehensive Cancer Network high-risk and very high-risk disease, respectively.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n The results of this meta-analysis suggest that, for men with localized prostate cancer treated with definitive radiotherapy and ADT, there are relative and absolute benefits from increasing durations of ADT that help provide individualized risk estimates.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamaoncol.2025.4800","type":"journal-article","created":{"date-parts":[[2025,11,20]],"date-time":"2025-11-20T16:01:24Z","timestamp":1763654484000},"page":"58","source":"Crossref","is-referenced-by-count":12,"title":["Optimal Duration of Androgen Deprivation Therapy With Definitive Radiotherapy for Localized Prostate Cancer"],"prefix":"10.1001","volume":"12","author":[{"given":"Nicholas G.","family":"Zaorsky","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology, University Hospitals Seidman Cancer Center, Case Western Reserve School of Medicine, Cleveland, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yilun","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, University Hospitals Seidman Cancer Center, Case Western Reserve School of Medicine, Cleveland, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdenour","family":"Nabid","sequence":"additional","affiliation":[{"name":"Centre hospitalier universitaire de Sherbrooke, Sherbrooke, Quebec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Almudena","family":"Zapatero","sequence":"additional","affiliation":[{"name":"Hospital Universitario de La Princesa, Instituto Investigaci\u00f3n Sanitaria, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michel","family":"Bolla","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, CHU Grenoble, Grenoble, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Joseph","sequence":"additional","affiliation":[{"name":"University of Western Australia, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philippe","family":"Maingon","sequence":"additional","affiliation":[{"name":"Sorbonne University, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Araceli","family":"Guerrero","sequence":"additional","affiliation":[{"name":"Hospital Son Espases, Illes Balears, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana Alvarez","family":"Gonzalez","sequence":"additional","affiliation":[{"name":"Hospital General Universitario Gregorio Mara\u00f1\u00f3n, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmen Gonzalez","family":"San-Segundo","sequence":"additional","affiliation":[{"name":"Hospital General Universitario Gregorio Mara\u00f1\u00f3n, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria \u00c1ngeles","family":"Cabeza Rodr\u00edguez","sequence":"additional","affiliation":[{"name":"Hospital Universitario 12 de Octubre, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josep Maria","family":"Sole","sequence":"additional","affiliation":[{"name":"Hospital Universitari Terrassa, Terrassa, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Agust\u00ed Pedro","family":"Oliv\u00e9","sequence":"additional","affiliation":[{"name":"Hospital Plat\u00f3, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allison","family":"Steigler","sequence":"additional","affiliation":[{"name":"School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luis","family":"Souhami","sequence":"additional","affiliation":[{"name":"McGill University Health Centre, Montreal, Quebec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathalie","family":"Carrier","sequence":"additional","affiliation":[{"name":"Centre hospitalier universitaire de Sherbrooke, Sherbrooke, Quebec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John G.","family":"Armstrong","sequence":"additional","affiliation":[{"name":"St Luke\u2019s Radiation Oncology Network and Cancer Trials, Dublin, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles","family":"Gillham","sequence":"additional","affiliation":[{"name":"St Luke\u2019s Radiation Oncology Network and Cancer Trials, Dublin, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas M.","family":"Pisansky","sequence":"additional","affiliation":[{"name":"Mayo Clinic, Rochester, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Schipper","sequence":"additional","affiliation":[{"name":"University of Michigan, Ann Arbor"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Howard M.","family":"Sandler","sequence":"additional","affiliation":[{"name":"Cedars Sinai Medical Center, Los Angeles, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason A.","family":"Efstathiou","sequence":"additional","affiliation":[{"name":"Massachusetts General Hospital, Harvard Medical School, Boston"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Colleen","family":"Lawton","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Medical College of Wisconsin Clinical Cancer Center, Milwaukee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theo M.","family":"de Reijke","sequence":"additional","affiliation":[{"name":"Department of Urology, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerhardt","family":"Attard","sequence":"additional","affiliation":[{"name":"University College of London, London, England"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soumyajit","family":"Roy","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Rush University, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott C.","family":"Morgan","sequence":"additional","affiliation":[{"name":"Division of Radiation Oncology, The Ottawa Hospital Cancer Centre, University of Ottawa, Ottawa, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shawn","family":"Malone","sequence":"additional","affiliation":[{"name":"Division of Radiation Oncology, The Ottawa Hospital Cancer Centre, University of Ottawa, Ottawa, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William A.","family":"Hall","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Medical College of Wisconsin Clinical Cancer Center, Milwaukee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul L.","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Dana-Farber\/Brigham Cancer Center, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan E.","family":"Shoag","sequence":"additional","affiliation":[{"name":"Department of Urology, University Hospitals Seidman Cancer Center, Case Western Reserve School of Medicine, Cleveland, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"Jr","given":"Randy A.","family":"Vince","sequence":"additional","affiliation":[{"name":"Department of Urology, University Hospitals Seidman Cancer Center, Case Western Reserve School of Medicine, Cleveland, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam","family":"Calaway","sequence":"additional","affiliation":[{"name":"Department of Urology, University Hospitals Seidman Cancer Center, Case Western Reserve School of Medicine, Cleveland, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorge A.","family":"Garcia","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, University Hospitals Seidman Cancer Center, Case Western Reserve School of Medicine, Cleveland, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pedro C.","family":"Barata","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, University Hospitals Seidman Cancer Center, Case Western Reserve School of Medicine, Cleveland, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prateek","family":"Mendiratta","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, University Hospitals Seidman Cancer Center, Case Western Reserve School of Medicine, Cleveland, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason R.","family":"Brown","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, University Hospitals Seidman Cancer Center, Case Western Reserve School of Medicine, Cleveland, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"Valle","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, University of California, Los Angeles"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Rettig","sequence":"additional","affiliation":[{"name":"Departments of Medicine and Urology, University of California, Los Angeles"},{"name":"Department of Medicine, VA Greater Los Angeles, Los Angeles, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert T.","family":"Dess","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, University of Michigan, Ann Arbor"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William C.","family":"Jackson","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, University of Michigan, Ann Arbor"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ting","family":"Martin","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, University of Washington, Seattle"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela Y.","family":"Jia","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, University Hospitals Seidman Cancer Center, Case Western Reserve School of Medicine, Cleveland, 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Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","reference":[{"issue":"2","key":"coi250070r1","doi-asserted-by":"crossref","first-page":"304","DOI":"10.1016\/S1470-2045(21)00705-1","article-title":"Androgen deprivation therapy use and duration with definitive radiotherapy for localised prostate cancer: an individual patient data meta-analysis.","volume":"23","author":"Kishan","year":"2022","journal-title":"Lancet Oncol"},{"issue":"10","key":"coi250070r2","doi-asserted-by":"crossref","first-page":"1067","DOI":"10.6004\/jnccn.2023.0050","article-title":"Prostate cancer, version 4.2023, NCCN clinical practice guidelines in oncology.","volume":"21","author":"Schaeffer","year":"2023","journal-title":"J Natl Compr Canc Netw"},{"issue":"3","key":"coi250070r3","doi-asserted-by":"crossref","DOI":"10.1001\/jamaoncol.2021.6871","article-title":"Interplay between duration of androgen deprivation therapy and external beam radiotherapy with or without a brachytherapy boost for optimal treatment of high-risk prostate cancer: a patient-level data analysis of 3 cohorts.","volume":"8","author":"Kishan","year":"2022","journal-title":"JAMA Oncol"},{"issue":"5","key":"coi250070r4","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1056\/NEJMoa1607529","article-title":"Radiation with or without antiandrogen therapy in recurrent prostate cancer.","volume":"376","author":"Shipley","year":"2017","journal-title":"N Engl J Med"},{"issue":"5","key":"coi250070r5","doi-asserted-by":"crossref","first-page":"825","DOI":"10.1016\/j.eururo.2014.07.010","article-title":"Adverse effects of androgen deprivation therapy and strategies to mitigate them.","volume":"67","author":"Nguyen","year":"2015","journal-title":"Eur Urol"},{"issue":"5","key":"coi250070r6","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1056\/NEJM199707313370502","article-title":"Improved survival in patients with locally advanced prostate cancer treated with radiotherapy and goserelin.","volume":"337","author":"Bolla","year":"1997","journal-title":"N Engl J Med"},{"issue":"24","key":"coi250070r7","doi-asserted-by":"crossref","first-page":"2516","DOI":"10.1056\/NEJMoa0810095","article-title":"Duration of androgen suppression in the treatment of prostate cancer.","volume":"360","author":"Bolla","year":"2009","journal-title":"N Engl J Med"},{"issue":"27","key":"coi250070r8","doi-asserted-by":"crossref","first-page":"3022","DOI":"10.1200\/JCO.21.00855","article-title":"Short androgen suppression and radiation dose escalation in prostate cancer: 12-year results of EORTC Trial 22991 in patients with localized intermediate-risk disease.","volume":"39","author":"Bolla","year":"2021","journal-title":"J Clin Oncol"},{"issue":"5","key":"coi250070r9","doi-asserted-by":"crossref","first-page":"671","DOI":"10.1016\/S1470-2045(22)00190-5","article-title":"High-dose radiotherapy and risk-adapted androgen deprivation in localised prostate cancer (DART 01\/05): 10-year 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with outcomes of long-term antiandrogen therapy in men with prostate cancer.","volume":"6","author":"Dess","year":"2020","journal-title":"JAMA Oncol"},{"issue":"2","key":"coi250070r28","doi-asserted-by":"crossref","first-page":"341","DOI":"10.1016\/j.ijrobp.2016.06.2445","article-title":"Late radiation and cardiovascular adverse effects after androgen deprivation and high-dose radiation therapy in prostate cancer: results from the DART 01\/05 randomized phase 3 trial.","volume":"96","author":"Zapatero","year":"2016","journal-title":"Int J Radiat Oncol Biol Phys"},{"issue":"1","key":"coi250070r29","doi-asserted-by":"crossref","first-page":"54","DOI":"10.2967\/jnumed.124.268441","article-title":"Low- and high-volume disease in metastatic hormone-sensitive prostate cancer: from CHAARTED to PSMA PET\u2014an international multicenter retrospective study.","volume":"66","author":"Unterrainer","year":"2025","journal-title":"J Nucl Med"}],"container-title":["JAMA 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