A meta-analysis of neo-adjuvant hormonal therapy for non-metastatic prostate cancer

Purpose: Radiotherapy plus radical prostatectomy or Neo-adjuvant Hormonal Therapy (NHT) after radiotherapy has been used for treating middle- and high-risk Prostate Cancer (PCa) patients. In this paper, we made a systematic review and meta-analysis of published randomized trials to assess the NHT clinical efficacy. Methods: Literatures related to neo-adjuvant hormone therapy (NHT plus chemotherapy or radical prostatectomy) and simple radiotherapy or the conventional therapy for prostate resection were collected from PubMed, EMBASE, Web of Science and Cochrane databases. RevMan5.2 statistical software was utilized for meta-analysis. The quality assessment of the literatures was performed based on the Cochrane risk bias. The similar information was derived from the tests which met the criteria, which was subject to meta-analysis collected before December 30th, 2015. Results: This study included 18 Randomized Controlled Trials (RCTs) consisting of a total of 6,223 patients. The meta-analysis showed the overall survival (OS) increased obviously (Odds Ratio (OR)=1.54, 95% Confidence Interval (CI) 1.24 to 1.83, P<0.005), Positive rate of Surgical resection Margin (PSM) (OR=0.31, 95% CI 0.21-0.39, P<0.005), biochemical Disease-Free Survival rate (bDFS) (OR=1.93, 95% CI 1.11-3.36, P=0.03), but there was no obvious difference between disease-free survival (OR=1.50, 95% CI 0.91-2.56, P=0.15) and clinical Disease-Free Survival rate (cDFS) (OR=0.93, 95% CI 0.24-4.16, P=0.92). Heterogenicity and risk bias existed among different studies. Conclusion: Compared with traditional treatment, neo-adjuvant hormonal therapy yields higher clinical efficacy and safety in the treatment of PCa.