Examining the role of neoadjuvant androgen deprivation in patients undergoing prostate brachytherapy Journal Article
| Authors: | Potters, L.; Torre, T.; Ashley, R.; Leibel, S. |
| Article Title: | Examining the role of neoadjuvant androgen deprivation in patients undergoing prostate brachytherapy |
| Abstract: | Purpose: To assess the role of neoadjuvant androgen deprivation (NAAD) and transperineal interstitial permanent prostate brachytherapy (TIPPB) using a matched-pair analysis selected from a large cohort of patients undergoing TIPPB. Patients and Methods: Six hundred twelve consecutive patients with clinically confined prostate cancer were treated between June 1992, and January 1997, with permanent ultrasound-guided TIPPB with either palladium- 103 or iodine-125 as monotherapy or combined with external radiation. Patients with prostate glands ≥ 60 g underwent treatment with NAAD before TIPPB to reduce the prostate volume (n = 163). The median duration of NAAD was 3.4 months before TIPPB (range, 1 to 8 months). To assess the benefit of NAAD, a matched-pair analysis was performed. The American Society of Therapeutic Radiology and Oncology Consensus Group definition of prostate- specific antigen (PSA) relapse-free survival (RFS) was used with the added caveat of an absolute increase of ≥ 1.0 ng/mL. Differences in pretreatment PSA, Gleason scores, and stage were analyzed by Kaplan-Meier curves and the log-rank test. Results: Two hundred sixty-three patients were matched, with a median follow-up duration of 46 months (range, 24 to 76 months). The actuarial 5-year PSA-RFS rate for all 263 patients is 86.5%. The 5-year PSA- RFS rote for patients treated with NAAD and TIPPB was 87.1% compared with 86.9% for those treated with TIPPB only (P = .935). Subgroup analysis by Gleason score groupings, pretreatment PSA, or stage of disease failed to identify any factors for which androgen ablation was beneficial. Conclusion: We were unable to identify any improvement with the addition of NAAD to TIPPB in patients with localized prostate cancer in this retrospective matched-pair analysis. Furthermore, there was no subset for which the addition of NAAD was found to be beneficial. Clarification of the role and duration of NAAD in patients with early-stage prostate cancer will require prospective data. (C) 2000 by American Society of Clinical Oncology. |
| Keywords: | adult; cancer survival; treatment outcome; survival analysis; retrospective studies; major clinical study; combined modality therapy; follow up; adenocarcinoma; prostate specific antigen; retrospective study; prostate cancer; prostatic neoplasms; iodine 125; androgen antagonists; brachytherapy; multivariate analysis; antineoplastic agents, hormonal; matched-pair analysis; palladium; neoplasms, hormone-dependent; humans; human; male; priority journal; article |
| Journal Title: | Journal of Clinical Oncology |
| Volume: | 18 |
| Issue: | 6 |
| ISSN: | 0732-183X |
| Publisher: | American Society of Clinical Oncology |
| Date Published: | 2000-03-13 |
| Start Page: | 1187 |
| End Page: | 1192 |
| Language: | English |
| PUBMED: | 10715287 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Export Date: 18 November 2015 -- Source: Scopus |
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