A metanalysis of 13 high quality studies with 10,000 patients: JAMA Oncology JAN 2026 : Definitive Radiotherapy and optimal ADT for Prostate gland confined disease. PET CT Scan Neg for metastasis
"... reduced estimated benefits being observed beyond androgen-deprivation therapy durations of 9 to 12 months. A near-linear increase in risk of mortality from causes other than prostate cancer was observed with longer deprivation,
0, 6, 9, 12 months of ADT
Intermediate: One risk factor, Two risk factors, high risk, and very high risk factors

uration of androgen-deprivation therapy (HR for 28 vs 0 months = 1.28, 95% CI = 1.09–1.50, P = .002). Compared with 36 months of treatment, risk of other-cause mortality was lower with 3 months (HR = 0.60, 95% CI = 0.45–0.80) and 6 months (HR = 0.77, 95% CI = 0.66–0.89).

The optimal androgen-deprivation therapy durations based on 10-year risk of distant metastasis were 0, 6, and 12 months and “undefined” for patients with one NCCN intermediate-risk factor, two or more NCCN intermediate-risk factors, NCCN high-risk disease, and NCCN very high-risk disease, respectively.