CHAMGAP
APPROVEDReviewed and approved by the Chamgap Editorial Team (2026-08-15). The draft was written by AI, the existence of all 2 cited sources was verified at the original page, and the verdict passed blind grading and adversarial audit. Methodology v0.7.
Verdict No. 2672 · Search date 2026-08-15 · Methodology v0.7

Four-month androgen deprivation plus radiotherapy,
does it really help with Improved overall survival and prostate-cancer mortality?

30-Second Summary
B
Evidence Grade B · 76 · Safety caution
Adding four months of androgen deprivation to radiotherapy improved ten-year survival and prostate-cancer mortality
Short-term androgen deprivation can cause hot flashes, sexual dysfunction, fatigue, and metabolic effects, while flutamide requires liver monitoring. An oncology specialist should weigh baseline risk against these harms.
What the
research shows
The grade is B with 76 points. RTOG 9408 randomized 2,028 men and analyzed 1,979 eligible participants. Ten-year overall survival was 57% with radiotherapy alone versus 62% with four-month androgen deprivation; the hazard ratio for death with radiotherapy alone was 1.17 (95% CI 1.01 to 1.35). At long follow-up, 18-year overall survival converged at 23%, but restricted mean survival was about six months longer and lower prostate-cancer mortality persisted with combined treatment.
What the
ads claim
This verdict applies to the RTOG 9408 regimen of four months of flutamide plus goserelin or leuprolide around radiotherapy. Longer hormonal therapy, postoperative treatment, and metastatic prostate cancer are different questions.
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Useful facts when choosing a product

  • Hormonal therapy began two months before radiotherapy and lasted four months.
  • The main and long-term papers report the same RTOG 9408 trial.
Gap Measurement · Verdict 2672 · B 76
What advertising claims
What independent, higher-quality research supports
△ GAP
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What the research actually shows

RTOG 9408 randomized 2,028 men at 212 centers but excluded 49 who were ineligible, withdrew consent, or lacked baseline data, leaving 1,979 in the primary analysis, 987 combined and 992 radiotherapy alone. The article designated overall survival as primary, consistent with NCT00002597. The National Cancer Institute sponsored the trial and drugs were purchased without commercial support. Excluding 49 participants after randomization prevents a complete allocation-based analysis.

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Why this is classified as B (76)

A large publicly funded trial improved overall survival and prostate-cancer mortality, but it remains one confirmatory trial and excluded 49 participants after randomization, giving B with 76 points.

Counterpoint. Benefit was unclear in low-risk disease, so baseline risk and adverse effects should guide treatment decisions.

Rejudgment record. Cross-check applied — Cross-checked the RTOG 9408 main report, long-term update, and NCT00002597 for the primary endpoint, randomized and analyzed counts, long-term survival, and NCI funding

Scoring profile behind this grade
EndpointHHard endpoint - actual events such as death
ReplicationR1Single confirmatory trial
IndependenceI2Decisive evidence is publicly or non-profit funded
Effect sizeE+Meets the clinically important threshold

The scoring table and the verdict agree (B).

Sub-claim grades by effect

This ingredient is marketed for several effects. A single overall grade blends strong and weak claims together, so each effect is graded separately here. The overall grade reflects the strongest disconfirming or core claim.

Effect (sub-claim)GradeBasis
Improved ten-year overall survivalBRates were 62% versus 57%.
Reduced prostate-cancer mortalityBTen-year rates were 4% versus 8%, with long-term HR 0.56.

Cross-check — Codex and Claude

This verdict was drafted by Codex through literature review and source-existence checks, cross-checked through blind grading and adversarial audit, and settled by reapplying the methodology boundary rules. Cases with split grades were resolved through rejudgment.
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Evidence Table

StudyDesignSampleFundingEndpointResultWeight
Study 1Multicenter phase 3 randomized trial and long-term report from the same trial992Public National Cancer Institute funding; no commercial supportOverall survivalTen-year overall survival 62% versus 57%; HR for death with radiotherapy alone 1.17 (95% CI 1.01 to 1.35). At 18 years, 23% versus 23%, restricted mean survival 11.8 versus 11.3 yearsSingle large publicly funded hard-outcome trial
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Receipt — 2 References

All 2 cited sources were verified for existence at the original page (as of 2026-08-15).

Jones CU, Hunt D, McGowan DG, Amin MB, Chetner MP, Bruner DW, Leibenhaut MH, Husain SM, Rotman M, Souhami L, Sandler HM, Shipley WU. Radiotherapy and short-term androgen deprivation for localized prostate cancer. N Engl J Med. 2011;365:107-118. PMID: 21751904. DOI: 10.1056/NEJMoa1012348. NCT00002597.
checked
Jones CU, Pugh SL, Sandler HM, Chetner MP, Amin MB, Bruner DW, Zietman AL, Den RB, Leibenhaut MH, Longo JM, Bahary JP, Rosenthal SA, Souhami L, Michalski JM, Hartford AC, Amin PP, Roach M, Yee D, Efstathiou JA, Rodgers JP, Feng FY, Shipley WU. Adding Short-Term Androgen Deprivation Therapy to Radiation Therapy in Men With Localized Prostate Cancer: Long-Term Update of the NRG/RTOG 9408 Randomized Clinical Trial. Int J Radiat Oncol Biol Phys. 2022;112:294-303. PMID: 34481017. DOI: 10.1016/j.ijrobp.2021.08.031. NCT00002597.
checked
Draft and rewrite: Codex (AI) · Verification: Codex blind grading and adversarial audit · Final adjudication: Claude
Reviewed and approved: Chamgap Editorial Team · Approval date: 2026-08-15 · Corrections: none

Cite this verdict

Four-month androgen deprivation plus radiotherapy x localized prostate cancer survival Evidence Grade B card
[Chamgap] Four-month androgen deprivation plus radiotherapy x localized prostate cancer survival — Evidence Grade B·76. 2 cited sources checked. Source: https://chamgap.com/en/verdicts/mens/short-term-adt-radiotherapy-localized-prostate-cancer-survival/ · CC BY 4.0

CC BY 4.0 — free to use with attribution; do not distort grades, numbers, or verdict meaning.

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What this document does and does not do

Chamgap is an information source. It reports what research has and has not confirmed; it does not tell readers what to take or buy. That decision belongs to readers and, when needed, medical or legal professionals. This verdict reflects literature available up to the search date and may change as new research appears. Nothing here is medical advice.