Objective: The strategy of androgen deprivation therapy (ADT) applied in patients with prostate cancer (PCa) to achieve optimal clinical and oncologic outcomes has been a longstanding debate. The objective of our study was to perform a meta?analysis to compare the efficacy, quality of life and adverse events profile of intermittent versus continuous androgen deprivation for prostate cancer. Methods: We searched PubMed, EMBASE and Web of Science to extract the basic characteristics. Besides, data of endpoint such as overall survival (OS), progression free survival (PFS), cancer?specific survival (CSS) and time to progression (TTP) as well as quality of life (QoL) were also collected. In addition, the results were expressed as hazard ratio (HR) with 95％ confidence interval (CI). Results: 17 articles including a total 6,733 patients with any stage of PCa were included in our review. No significant differences were found in PFS (HR = 0.93, 95％ CI: 0.83?1.03), TTP (HR = 0.96, 95％ CI: 0.84?1.07) between intermittent androgen deprivation (IAD) and continuous androgen deprivation (CAD), whereas CAD showed benefits associated with OS (HR = 0.92, 95％ CI: 0.85?0.98) and CSS (HR = 0.86, 95％ CI: 0.74?0.98). In addition, IAD might have a superior outcome compared with CAD, especially in sexual functioning and headache favoring. Controversial outcomes were also seen in some aspects such as hotflushes, gynecomastia, breast pain or fatigue. Conclusion: PFS and TTP were similar between IAD and CAD, whereas CAD showed benefits associated with OS and CSS. IAD might have benefits in QoL and have less adverse effects, especially in sexual dysfunction and headache.
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