The review article of Bhandari (1) and original report of Niraula (2) were designed to determine

whether the intermittent androgen-deprivation therapy (IAD) is superior over continuous

androgen-deprivation therapy (CAD) in different patients with PSA relapsing, locally advanced,
or metastatic prostate cancer. According to Niraula, hazard ratio of overall survival (OS) was
1.02 for IAD in comparison with CAD. Additionally, there were more deaths related to prostate
cancer with IAD and more deaths which are not related to prostate cancer with CAD. However,
there were some differences in quality of life (QoL) between IAD and CAD. Patients with IAD
had better points on some aspects of QoL and less treatment-related side effects such as sexual
and physical dysfunctions. Finally, there is a good evidence to recommend the use of IAD
instead of CAD in the treatment of PSA relapsing or metastatic prostate cancer. Although, the
treatment with IAD requires initial reduction of PSA to low level, and only in that case patients
are appropriate to use IAD.
Citation due to PubMed:
1. Bhandari MS, Crook J, Hussain M. Should intermittent androgen deprivation be
used in routine clinical practice? J Clin Oncol. 2005 Nov 10;23(32):8212-8.
Review. PubMed PMID: 16278475.

2. Niraula S, Le LW, Tannock IF. Treatment of prostate cancer with intermittent

versus continuous androgen deprivation: a systematic review of randomized trials.
J Clin Oncol. 2013 Jun 1;31(16):2029-36. doi: 10.1200/JCO.2012.46.5492. Epub 2013
Apr 29. Review. PubMed PMID: 23630216.