Survival benefit associated with adjuvant androgen deprivation therapy combined with radiotherapy for high- and low-risk patients with nonmetastatic prostate cancer.

Zeliadt SB, Potosky AL, Penson DF, Etzioni R
Int J Radiat Oncol Biol Phys. 2006 66 (2): 395-402

PMID: 16904843 · DOI:10.1016/j.ijrobp.2006.04.048

BACKGROUND - The use of adjuvant androgen deprivation therapy (ADT) combined with radiotherapy has become common in low-risk patients, although clinical trials have focused primarily on high-risk patients. This study examines the effectiveness of adjuvant ADT combined with radiotherapy for a wide range of patients treated in the 1990s.

METHODS AND MATERIALS - Prostate cancer survival was examined in a population based cohort of 31,643 patients aged 65 to 85 years who were diagnosed with nonmetastatic prostate cancer and treated with external beam radiotherapy and/or brachytherapy. Instrumental variable analysis methods were used to control for selection bias.

RESULTS - Patients with stage T3/T4 disease who received adjuvant ADT experienced improved 5-year and 8-year survival. No survival advantage was observed for men with T1/T2 disease during this interval.

CONCLUSION - High-risk patients who receive primary radiotherapy have benefited from adjuvant ADT, whereas low-risk patients with disease confined to the prostate have not yet benefited from adjuvant therapy within the first 8 years after treatment. These findings are consistent with practice guidelines, which recommend adjuvant ADT for patients with high-risk disease.

MeSH Terms (12)

Aged Aged, 80 and over Androgen Antagonists Chemotherapy, Adjuvant Humans Male Neoplasm Staging Proportional Hazards Models Prostatic Neoplasms SEER Program Socioeconomic Factors Survival Analysis

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