Importance: @entity342 deprivation is the standard therapy for @entity1 with advanced or recurrent @entity263 . However, this treatment causes adverse effects, alters quality of life, and may lead to castration-resistant disease. Intermittent @entity342 deprivation has been studied as an alternative. Objective: To conduct a systematic review and meta-analysis comparing the efficacy and tolerability of intermittent vs continuous @entity342 deprivation therapy in @entity1 with @entity263 . Data Sources: We searched Cochrane CENTRAL, Medline, Embase, Web of Science, Biosis, National Technical Information Service, OpenSIGLE, and Google Scholar from inception of each database through March 2014. References from published guidelines, reviews, and other relevant articles were also considered. Study Selection: We selected randomized clinical trials comparing intermittent vs continuous @entity342 deprivation therapy in @entity1 with @entity263 . Data Extraction and Synthesis: Two reviewers performed study selection, data abstraction, and risk of bias assessment. We calculated hazard ratios (HRs) with the inverse variance method and risk ratios with the Mantel-Haenszel method, using random effect models. A noninferiority analysis was conducted for overall survival with a margin of 1.15 for the upper boundary of the HR. We assessed heterogeneity using the I2 index. Main Outcomes and Measures: Primary outcomes were overall survival and quality of life. Secondary outcomes were @entity5 -specific survival, progression-free survival, time to castration resistance, skeletal-related events, and adverse effects. Results: From 10   510 references, we included 22 articles from 15 trials (6856 @entity1 ) published between 2000 and 2013. All but 1 study had an unclear or high risk of bias. We observed no significant difference between intermittent and continuous therapy for overall survival (HR, 1.02; 95% CI, 0.93-1.11; 8 trials, 5352 @entity1 ), @entity5 -specific survival (HR, 1.02; 95% CI, 0.87-1.19; 5 trials, 3613 @entity1 ), and progression-free survival (HR, 0.94; 95% CI, 0.84-1.05; 4 trials, 1774 @entity1 ). There was minimal difference in @entity1 ' self-reported quality of life between the 2 interventions. Most trials observed an improvement in physical and sexual functioning with intermittent therapy. Conclusions and Relevance: Intermittent @entity342 deprivation was not inferior to continuous therapy with respect to the overall survival. Some quality-of-life criteria seemed improved with intermittent therapy. Intermittent @entity342 deprivation can be considered as an alternative option in @entity1 with recurrent or metastatic @entity263 .

Intermittent vs Continuous XXXX Deprivation Therapy for @entity263 : A Systematic Review and Meta-analysis.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity5 :: ('MESH:D009369', 'Disease') :: ['cancer'] @entity263 :: ('MESH:D011471', 'Disease') :: ['prostate cancer'] @entity342 :: ('CHEBI:50113', 'Chemical') :: ['androgen', 'Androgen']
@entity342 :: (CHEBI:50113,Chemical) :: ['Androgen']
