Short-term androgen-deprivation therapy improves prostate cancer-specific mortality in intermediate-risk prostate cancer patients undergoing dose-escalated external beam radiation therapy Journal Article


Authors: Zumsteg, Z. S.; Spratt, D. E.; Pei, X.; Yamada, Y.; Kalikstein, A.; Kuk, D.; Zhang, Z.; Zelefsky, M. J.
Article Title: Short-term androgen-deprivation therapy improves prostate cancer-specific mortality in intermediate-risk prostate cancer patients undergoing dose-escalated external beam radiation therapy
Abstract: Purpose: We investigated the benefit of short-term androgen-deprivation therapy (ADT) in patients with intermediate-risk prostate cancer (PC) receiving dose-escalated external beam radiation therapy. Methods and Materials: The present retrospective study comprised 710 intermediate-risk PC patients receiving external beam radiation therapy with doses of ≥81 Gy at a single institution from 1992 to 2005, including 357 patients receiving neoadjuvant and concurrent ADT. Prostate-specific antigen recurrence-free survival (PSA-RFS) and distant metastasis (DM) were compared using the Kaplan-Meier method and Cox proportional hazards models. PC-specific mortality (PCSM) was assessed using competing-risks analysis. Results: The median follow-up was 7.9 years. Despite being more likely to have higher PSA levels, Gleason score 4 + 3 = 7, multiple National Comprehensive Cancer Network intermediate-risk factors, and older age (P≤.001 for all comparisons), patients receiving ADT had improved PSA-RFS (hazard ratio [HR], 0.598; 95% confidence interval [CI], 0.435-0.841; P=.003), DM (HR, 0.424; 95% CI, 0.219-0.819; P=.011), and PCSM (HR, 0.380; 95% CI, 0.157-0.921; P=.032) on univariate analysis. Using multivariate analysis, ADT was an even stronger predictor of improved PSA-RFS (adjusted HR [AHR], 0.516; 95% CI, 0.360-0.739; P<.001), DM (AHR, 0.347; 95% CI, 0.176-0.685; P=.002), and PCSM (AHR, 0.297; 95% CI, 0.128-0.685; P=.004). Gleason score 4 + 3 = 7 and ≥50% positive biopsy cores were other independent predictors of PCSM. Conclusions: Short-term ADT improves PSA-RFS, DM, and PCSM in patients with intermediate-risk PC undergoing dose-escalated external beam radiation therapy. © 2013 Elsevier Inc. All rights reserved.
Journal Title: International Journal of Radiation Oncology, Biology, Physics
Volume: 85
Issue: 4
ISSN: 0360-3016
Publisher: Elsevier Inc.  
Date Published: 2013-03-15
Start Page: 1012
End Page: 1017
Language: English
DOI: 10.1016/j.ijrobp.2012.07.2374
PROVIDER: scopus
PUBMED: 22981709
DOI/URL:
Notes: --- - "Export Date: 1 April 2013" - "CODEN: IOBPD" - "Source: Scopus"
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MSK Authors
  1. Zhigang Zhang
    240 Zhang
  2. Michael J Zelefsky
    615 Zelefsky
  3. Yoshiya Yamada
    357 Yamada
  4. Deborah Kuk
    81 Kuk
  5. Zachary Stephan Zumsteg
    34 Zumsteg
  6. Daniel Eidelberg Spratt
    83 Spratt
  7. Xin Pei
    98 Pei