The Absolute Effect / Evidence / RTOG 92-02
Prostate Cancer · Radiation · Locally advanced
RTOG 92-02
Clinical question
Does extending ADT from 4 months to about 28 months with radiotherapy improve outcomes in locally advanced prostate cancer?
Trial context
Population
1,554 men
Intervention
All: 4 months goserelin + flutamide with RT; experimental: additional 24 months goserelin. RT 45 Gy pelvis + 65–70 Gy prostate.
Comparator
4-month ADT + RT
Primary / key evidence
At 10 y: disease-free survival 22.5% vs 13.2%; distant metastasis 14.8% vs 22.8%; OS 53.9% vs 51.6% (p=.36).
Absolute Effect
What changes for patients?
At 10 y: disease-free survival 22.5% vs 13.2%; distant metastasis 14.8% vs 22.8%; OS 53.9% vs 51.6% (p=.36).
NNT/NNH: Not calculated unless a defensible fixed-time event-rate comparison was available in the cited primary analysis; median-survival differences alone are not converted to NNT.
Clinical interpretation
Long-term ADT improved disease control and disease-specific outcomes; the overall-survival effect was not significant in the whole cohort, with benefit in Gleason 8–10 subgroup.
Limitations / maturity
Interpret the effect in the context of the trial population, endpoint definition, follow-up and treatment era. Subsequent trials and evolving standards may limit direct applicability to contemporary patients.
Primary publication
Horwitz EM et al. J Clin Oncol. 2008;26:2497–2504.