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:	http://www.scopus.com/inward/record.url?eid=2-s2.0-84875214812&partnerID=40&md5=5e5f591a896b3c3a8cbb8cc67d1e72e5
Notes:	--- - "Export Date: 1 April 2013" - "CODEN: IOBPD" - "Source: Scopus"

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