The Effects Of Intermittent Hormonal Therapy Versus Continuous Hormonal Therapy For Prostate Cancer: A Meta-analysis

AIM: To compare the efficacy and safety of intermittent hormonal therapy(IHT)versus continuous hormonal therapy(CHT)in treating prostate cancer. MATERIALS AND METHODS: We conducted a thorough search of Pub Med, EMBASE, Cochrane-Library, Web of Science databases, Sinomed, Wan Fang database,VIP database and CNKI by computer and search Chinese Journal of Urology, Chinese Journal of Andrology and National Journal of Andrology by human,to include all randomized controlled trials comparing IHT with CHT in the therapy of prostate cancer. We assessed the quality of the reports included in this meta-analysis and the Review Manager 5.2 was used for data analysis. RESULTS: We identified 21 reports, in which with 7291 patients, overall survival(various clinical stages: HR=0.92,p=0.11; M0 stages: HR=0.98,p=0.70; M1 stages: HR=1.04,p=0.37), time to progression(TTP)(HR=0.98,p=0.61) and prostate cancer-specific deaths(HR=1.03,p=0.69) were similar in all patients received IHT or CHT. The prevalence of adverse events of IHT and CHT was as follows: hot flushes(RR=0.70,p<0.00001), the group in Chinese(RR=0.48,p<0.00001), the group in English(RR=0.78,p<0.00001); gynecomastia(RR=0.34,p<0.00001),the group in Chinese(RR=0.39,p<0.00001),the group in English(RR=0.46,p<0.00001); fatigue(RR=0.74, p=0.06); liver enzyme increase(RR=0.47, p=0.03); headache(RR=0.67, p<0.00001); erectile dysfunction( RR=1.06, p=0.90); depression(RR=0.72, p=0.18);osteoporosis(RR=0.73,p=0.006);anemia(RR=0.24,p=0.04). The rate of hot flushes, gynecomastia, liver enzyme increase, headache, osteoporosis, anemia in IHT was less than in CHT. However, the rate of fatigue, erectile dysfunction, depression IHT was similar as in CHT. CONCLUSION: Our findings support IHT as a reasonable option which with the similar OS, TTP and prostate cancer-specific deaths and lower rate of side effects.