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Addition of short-term androgen deprivation therapy to dose-escalated radiation therapy improves failure-free survival for select men with intermediate-risk prostate cancer.
Bian, S X; Kuban, D A; Levy, L B; Oh, J; Castle, K O; Pugh, T J; Choi, S; McGuire, S E; Nguyen, Q N; Frank, S J; Nguyen, P L; Lee, A K; Hoffman, K E.
Afiliação
  • Bian SX; Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston; Baylor College of Medicine, Houston.
  • Kuban DA; Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston.
  • Levy LB; Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston.
  • Oh J; Department of Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston.
  • Castle KO; Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston.
  • Pugh TJ; Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston.
  • Choi S; Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston.
  • McGuire SE; Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston.
  • Nguyen QN; Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston.
  • Frank SJ; Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston.
  • Nguyen PL; Department of Radiation Oncology, Dana Farber/Brigham and Women's Cancer Center, Harvard Medical School, Boston, USA.
  • Lee AK; Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston.
  • Hoffman KE; Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston. Electronic address: khoffman1@mdanderson.org.
Ann Oncol ; 23(9): 2346-2352, 2012 Sep.
Article em En | MEDLINE | ID: mdl-22357249
BACKGROUND: Dose-escalated (DE) radiation therapy (RT) and androgen deprivation therapy (ADT) improve prostate cancer outcomes over standard-dose RT. The benefit of adding ADT to DE-RT for men with intermediate-risk prostate cancer (IR-PrCa) is uncertain. PATIENTS AND METHODS: We identified 636 men treated for IR-PrCa with DE-RT (>75Gy). The adult comorbidity evaluation-27 index classifed comorbidity. Kaplan-Meier and log-rank tests compared failure-free survival (FFS) with and without ADT. RESULTS: Forty-five percent received DE-RT and 55% DE-RT with ADT (median 6 months). On Cox proportional hazard regression that adjusted for comorbidity and tumor characteristics, ADT improved FFS (adjusted hazard ratio 0.36; P = 0.004). Recursive partitioning analysis of men without ADT classified Gleason 4 + 3 = 7 or ≥50% positive cores as unfavorable disease. The addition of ADT to DE-RT improved 5-year FFS for men with unfavorable disease (81.6% versus 92.9%; P = 0.009) but did not improve FFS for men with favorable disease (96.3% versus 97.4%; P = 0.874). When stratified by comorbidity, ADT improved FFS for men with unfavorable disease and no or mild comorbidity (P = 0.006) but did not improve FFS for men with unfavorable disease and moderate or severe comorbidity (P = 0.380). CONCLUSION: The addition of ADT to DE-RT improves FFS for men with unfavorable IR-PrCa, especially those with no or minimal comorbidity.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias da Próstata / Antagonistas de Androgênios / Neoplasias Hormônio-Dependentes / Antineoplásicos Tipo de estudo: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Aged / Humans / Male Idioma: En Ano de publicação: 2012 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias da Próstata / Antagonistas de Androgênios / Neoplasias Hormônio-Dependentes / Antineoplásicos Tipo de estudo: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Aged / Humans / Male Idioma: En Ano de publicação: 2012 Tipo de documento: Article