***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Purpose Patients with advanced prostate cancer ( PCa ) benefit from intermittent maximal and rogen blockade ( IMAB ) therapy when time-off period ( TOP ) is extended . A comparative study included patients who received uninterrupted finasteride ( mMAB ) treatment and those who did not MAB .  Methods A r and omized group of 63 patients with PCa ( T3NxM1 ; Gl . 6 - 7 ) was prospect ively examined for 5 years : group A (GrA)—31 patients receiving MAB and group B (GrB)—32—mMAB . Testosterone inactivating pharmaceuticals period ( TIP ) lasted until PSA was 0.2 ng/ml ( group A ) and 0.1 ng/ml ( group B ) , followed by MAB ( TOP ) discontinuation . CR , PR , BP , and TP evaluation criteria were adopted . Tests were carried out every 3 months . Results After 5 years , five patients in GrA did not reach PSA concentration nadir value and were eliminated from final evaluation . TIP1 for both groups was comparable ; TIP2 - 4 were shorter in GrB. TOP1 - 3 for GrB were longer than in GrA , and TOP4 was comparable in both groups . Treatment effects were , respectively , CR , 1(3.2 % ) and 17(53 % ) ; PR , 9(29 % ) and 3(9 % ) ; BP 11(35.5 % ) and 5(15.6 % ) ; TP , 10(32.2 % ) and 7(22 % ) . Before the therapy , QoL of 63 patients was between 4 and 5 points ; after 5 years for patients with CR and PR , between 1 and 2 points , but for BP , between 3 and 4 points . Conclusions Better therapy effects were observed in patients treated with mMAB  , receiving additional finasteride . Response to the treatment improved by nearly double , and progression was two times lower . TOP after TIP was extending in time Background : Patients who develop castration-resistant prostate cancer ( CRPCa ) typically continue on and rogen deprivation therapy ( ADT ) . Whether these patients need to remain on ADT has not been well studied . We conducted a multicenter r and omized trial to compare an intermittent versus continuous approach to ADT in CRPCa patients .  Overall survival , health-related quality of life ( QOL ) , and cost were the main endpoints . Methods : CRPCa patients were r and omized 2:1 to intermittent or continuous luteinizing hormone-releasing hormone agonists ( LHRHa ) .  Patients were followed with clinical assessment s , laboratory investigations , and QOL question naires ( EORTC QLQ-C30 or PROSQOLI ) every 2 months . If the serum testosterone rose above castrate levels ( 1.75 nmol/L ) , LHRHa were reinitiated . The study was design ed to close if > 50 % of patients needed to restart ADT in the intermittent arm . Results : Thirty-one patients were followed with a median follow-up of 26.8 months—18 in the intermittent arm and 13 in the continuous . Twelve of 18 patients on the intermittent arm were reinitiated on LHRHa at a median time of 17.9 months . There was no difference in overall or cancer-specific survival between the 2 arms . There was no statistically significant difference in QOL between the 2 arms at 0 and 12 months . The total mean costs at 24 months were significantly lower in the intermittent arm ( $ 3135 vs. $ 8253 Canadian dollars , P=0.0167 ) compared with the continuous . The main limitation of this study is the small sample size . Conclusions : We have observed that intermittent ADT in patients with CRPCa , using a testosterone of > 1.75 ngmol/L as a trigger to reinitiate LHRHa , results in a substantial cost savings with no negative impact on oncologic and QOL outcomes BACKGROUND Castration resistance occurs in most patients with metastatic hormone-sensitive prostate cancer who are receiving and rogen-deprivation therapy .  Replacing and rogens before progression of the disease is hypothesized to prolong and rogen dependence . METHODS Men with newly diagnosed , metastatic , hormone-sensitive prostate cancer , a performance status of 0 to 2 , and a prostate-specific antigen ( PSA ) level of 5 ng per milliliter or higher received a luteinizing hormone-releasing hormone analogue and an anti and rogen agent for 7 months . We then r and omly assigned patients in whom the PSA level fell to 4 ng per milliliter or lower to continuous or intermittent and rogen deprivation  , with patients stratified according to prior or no prior hormonal therapy , performance status , and extent of disease ( minimal or extensive ) . The co primary objectives were to assess whether intermittent  therapy  was noninferior to continuous therapy with respect to survival , with a one-sided test with an upper boundary of the hazard ratio of 1.20 , and whether quality of life differed between the groups 3 months after r and omization . RESULTS A total of 3040 patients were enrolled , of whom 1535 were included in the analysis : 765 r and omly assigned to continuous and rogen deprivation and 770 assigned to intermittent and rogen deprivation . The median follow-up period was 9.8 years . Median survival was 5.8 years in the continuous-therapy group and 5.1 years in the intermittent-therapy group ( hazard ratio for death with intermittent therapy , 1.10 ; 90 % confidence interval , 0.99 to 1.23 ) . Intermittent therapy was associated with better erectile function and mental health ( P<0.001 and P=0.003 , respectively ) at month 3 but not thereafter . There were no significant differences between the groups in the number of treatment-related high- grade adverse events . CONCLUSIONS Our findings were statistically inconclusive . In patients with metastatic hormone-sensitive prostate cancer , the confidence interval for survival exceeded the upper boundary for noninferiority , suggesting that we can not rule out a 20 % greater risk of death with intermittent therapy than with continuous therapy , but too few events occurred to rule out significant inferiority of intermittent therapy . Intermittent therapy result ed in small improvements in quality of life . ( Funded by the National Cancer Institute and others ; Clinical Trials.gov number , NCT00002651 . ) PURPOSE To evaluate the optimal duration of and rogen deprivation therapy ( ADT ) in patients with prostate cancer treated with external beam radiotherapy ( EBRT ) , who present with PSA levels > 20 ng/mL. METHODS AND MATERIAL S A total of 307 patients presenting with a PSA > 20 ng/ml were treated with EBRT and ADT .  The cohort was divided into four groups according to the duration of ADT : Group 1 received < 6 months ( n = 71 ) , group 2 received 6 - 12 months ( n = 80 ) , group 3 received 12 - 24 months ( n = 72 ) , and group 4 received > 24 months ( n = 84 ) of ADT . The endpoints analyzed were biochemical control ( bNED ) , overall survival ( OS ) and cause-specific survival ( CSS ) . Statistical analysis was conducted using Kaplan-Meier estimates and Cox regression models . RESULTS Compared to patients who received < 6 months of ADT , patients treated with 12 - 24 months or > 24 months of ADT experienced significantly improved bNED ( p = 0.01 and p < 0.0001 , respectively ) . Cause-specific survival with ADT duration s 12 - 24 and > 24 months were significantly higher compared to < 6 months ( p < 0.007 and 0.024 , respectively ) . Overall survival with ADT duration s > 24 months was also significantly higher compared to < 6 months ( p = 0.0025 ) . CONCLUSIONS The present analysis supports the hypothesis that longer duration s of ADT  improves bNED , CSS and OS in patients presenting with a PSA > 20 ng/ml Background : Intermittent and rogen deprivation ( IAD ) for prostate cancer was studied with the objective of reducing the side effects of treatment and potentially delaying the development of hormone resistance . There also appears to be a quality of life benefit during off-treatment intervals owing to the recovery of serum testosterone levels . Methods : In this multicentre European prospect i ve r and omised phase III trial EC507 , testosterone serum concentrations were analysed in prostate cancer patients with PSA progression after radical prostatectomy . Patients were r and omised to a continuous and rogen deprivation ( CAD ) and IAD therapy using a 3-month depot with 11.25 mg leuprorelin acetate as microcapsule formulation . A complete IAD cycle comprises both a 6-month and rogen deprivation therapy plus the off-treatment time ( OTT ) . Results : Serum testosterone recovery was recorded in 109 patients during OTT in the IAD group . Testosterone recovery to baseline values was achieved in 79.3 % during the first and in 64.9 % during the second IAD cycle , respectively . Median time to testosterone normalisation was 100 days in the first and 115 days in the second cycle , respectively . No significant difference was observed up to 1000 days between IAD and CAD with regard to time to and rogen-independent progression . This is the first prospect i ve study of leuprorelin acetate 11.25 mg demonstrating normalisation of testosterone levels in the off-treatment period in patients undergoing IAD . Conclusions : The prerequisite of an IAD treatment is the testosterone recovery during off-treatment periods . In this study , in patients with PSA relapse after radical prostatectomy , a real achievement of intermittent castration with normalisation of testosterone levels during off-treatment periods could be confirmed OBJECTIVE To evaluate systematic ally interrupted and rogen suppression ( SIAS ) 6 mo a year compared with continuous and rogen suppression ( CAS ) in prostate cancer treatment . PATIENTS AND METHODS All patients underwent maximal and rogen blockade for 6 mo . Then , depending on the r and omisation arm , they continued ( CAS ) or stopped their treatment for 6 mo before they resumed it a year later and so on ( SIAS ) . Primary end points were patient 's health-related quality of life ( HQOL ) and time to progression . Secondary end points were cancer-specific and overall survival . Progression was defined by a clinical event or PSA value exceeding double the value obtained at the end of the first 6 mo of therapy . RESULTS Sixty-two patients were r and omised to CAS and 67 to SIAS .  There were no significant differences between groups at baseline . And rogen suppression was associated with HQOL deterioration except for an improvement in urinary symptoms . The 6-mo off-therapy period was not long enough to regain normal testosterone values . There was no difference in HQOL scores between CAS and SIAS except that men in the latter group reported a greater need for painkillers but a better ability to have an erection . Progression occurred in 62 patients ( 48.1 % ) with no significant difference between CAS and SIAS with a mean follow-up of 44.8 mo . Death occurred in 41 patients and specific death in 19 patients ( 10 % and 19 % of the CAS and SIAS groups , respectively ) . CONCLUSIONS Although patients in the SIAS group were maintained off-therapy 50 % of the time , insufficient testosterone recovery in this group likely explains why differences between the two groups were moderate or absent with regards to HQOL and survival , respectively PURPOSE To clarify the optimal duration and methods for adjuvant endocrine therapy after external beam radiation therapy ( EBRT ) in patients with locally advanced prostate cancer . MATERIAL S AND METHODS Between 2001 and 2003 , 215 patients with locally advanced prostate cancer were enrolled in the study . Patients were registered as primary c and i date s of the study and were treated with 6 months of LHRH agonist , with short-term of anti and rogen treatment for flare-up prevention .  Patients with PSA levels below 10 ng/ml after the 6-month endocrine treatment  were r and omly divided into two arms . Then , a total dose of 72 Gy was given to the prostate . After 14 months of the protocol treatment , patients were treated with continuous and rogen ablation ( arm 1 ) or intermittent and rogen ablation ( arm 2 ) . RESULTS A total of 188 cases ( 87 % ) remained in the protocol . The median PSA level at entry was 25.3 ng/ml . The Gleason score was 2 - 6 in 32 cases ( 16 % ) , 7 in 94 cases ( 48 % ) , and 8 - 10 in 68 cases ( 35 % ) . The median PSA level showed a remarkable decrease to 1.1 , 0.2 , and 0.1 ng/ml , after 6 , 8 , and 14 months of the protocol treatment , respectively . Of the 157 cases treated with EBRT , 153 cases ( 97.5 % ) had no biochemical failure in the mean follow-up of 17.3 months . CONCLUSIONS The present study may reveal the possibilities of intermittent endocrine therapy after EBRT . However , the follow-up interval is short and little can be said about the results observed so far , exception of acute tolerance and patient acceptance of the protocol The aim of this study was to compare the efficacy of total intermittent and rogen deprivation ( IAD ) versus total continuous and rogen depriv 
    Output:
    
Most studies found an improvement in quality of life or toxicity profile with IAD .
Conclusions : IAD is non-inferior to CAD in terms of OS and cancer-specific survival , and is at least non-inferior in terms of time to progression .
This meta- analysis confirms IAD as a valid st and ard of care for managing prostate cancer patients