Objective: To assess clinical practice of intermittent hormone therapy (IHT) among urologists members of the French Association of Urology.
Methods: Internet-based observational survey evaluating IHT modalities in prostate cancer using questionnaire sent to 941 urologists.
Results: Two hundred and sixty nine urologists participated in the survey (response rate 28.6 %) including 90.3 % prescribing IHT. The main reasons for IHT were improvement of quality of life in 94.2 %, clinical tolerance in 73.7 %, decreased costs and oncological equivalence in 44 %. The indications were localized prostate cancer (low risk 22.6 %, intermediate 19.8 %, high 14 %), locally advanced (59.7 %), metastatic (63.4 %), biochemical recurrence after local treatment (prostatectomy 62.1 %, radiotherapy 73.7 %). A PSA <2 ng/mL was considered as the threshold for androgen deprivation therapy break in 70 % of cases regardless of the IHT indication. The PSA threshold selected for the re-initiation of treatment was 4 ng/mL in 37.9 % and 10 ng/mL in 36.6 % of cases. The cycle of IHT was 6 months in 60 % of cases.
Conclusion: This survey provided a snapshot of the practice of IHT in France. Even in the absence of level of evidence 1 trials in the literature, most urologists used IHT in their clinical practice, for many indications, especially in case of biochemical recurrence after local treatment.
Level of proof: 3.
Keywords: Cancer de la prostate; Intermittent hormonal treatment; Outcomes; Prostate cancer; Quality of life; Qualité de vie; Résultats; Traitement hormonal intermittent.
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