Impact of androgen deprivation therapy in patients with unfavorable intermediate-risk prostate cancer receiving brachytherapy-based dose-escalated radiation therapy.
Nikhil T Sebastian, Subir Goyal, Yuan Liu, Vishal Dhere, Ashesh B Jani, Bruce Hershatter, Pretesh R Patel, Jay W Shelton, Sheela Hanasoge, Karen D Godette, Sagar A Patel
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引用次数: 0
Abstract
Purpose: While the benefit of short-term androgen deprivation therapy (ADT) has been established for patients with intermediate-risk (IR) prostate cancer (PCa) receiving dose-escalated external beam radiation therapy (EBRT), the role of ADT for patients treated with brachytherapy (BT) with or without supplemental EBRT (sEBRT) is less clear.
Material and methods: We conducted a single-institution retrospective analysis of men with National Comprehensive Cancer Network (NCCN) unfavorable IR (UIR) PCa. All patients received BT with or without sEBRT, and were stratified by the receipt of 4-6 months of ADT. Kaplan-Meier method was used to measure biochemical progression- free survival (bPFS) between men who did vs. did not receive ADT. Multivariable Cox proportional hazards with backward selection was utilized to determine association of concomitant ADT with bPFS accounting for confounding variables.
Results: We identified 201 eligible patients treated between 2002 and 2019, 78 (38.8%) of whom received ADT. Median follow-up was 15 years. On univariable analysis, there was no significant association of ADT use with bPFS (HR = 0.95, 95% CI: 0.34-2.63, p = 0.92). Only PSA ≥ 10 was significant for association with worse bPFS (HR = 3.51, 95% CI: 1.29-9.52, p = 0.014). On multivariable analysis, there was no association of ADT use with bPFS (HR = 0.97, 95% CI: 0.34-2.78, p = 0.96).
Conclusions: Short-course ADT was not associated with improved bPFS in our study among men with UIR PCa treated with BT with or without sEBRT. These findings suggest that dose intensification achieved with BT may alone be sufficient in treating selected patients with UIR disease, but prospective studies are warranted.
期刊介绍:
The “Journal of Contemporary Brachytherapy” is an international and multidisciplinary journal that will publish papers of original research as well as reviews of articles. Main subjects of the journal include: clinical brachytherapy, combined modality treatment, advances in radiobiology, hyperthermia and tumour biology, as well as physical aspects relevant to brachytherapy, particularly in the field of imaging, dosimetry and radiation therapy planning. Original contributions will include experimental studies of combined modality treatment, tumor sensitization and normal tissue protection, molecular radiation biology, and clinical investigations of cancer treatment in brachytherapy. Another field of interest will be the educational part of the journal.