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Mortality in men with localized prostate cancer treated with brachytherapy with or without neoadjuvant hormone therapy†
Article first published online: 5 JAN 2010
Copyright © 2010 American Cancer Society
Volume 116, Issue 4, pages 837–842, 15 February 2010
How to Cite
Dosoretz, A. M., Chen, M.-H., Salenius, S. A., Ross, R. H., Dosoretz, D. E., Katin, M. J., Mantz, C., Nakfoor, B. M. and D'Amico, A. V. (2010), Mortality in men with localized prostate cancer treated with brachytherapy with or without neoadjuvant hormone therapy. Cancer, 116: 837–842. doi: 10.1002/cncr.24750
Presented at the 2008 Annual Meeting of the American Society for Therapeutic Radiology and Oncology, Boston, Massachusetts, September 21-25, 2008.
- Issue published online: 2 FEB 2010
- Article first published online: 5 JAN 2010
- Manuscript Accepted: 13 MAY 2009
- Manuscript Revised: 6 MAY 2009
- Manuscript Received: 20 FEB 2009
- prostate cancer;
- androgen deprivation;
- neoadjuvant hormone therapy;
- radiation therapy
Discrepancies exist regarding the impact of neoadjuvant hormone therapy (NHT) on the risk of all-cause mortality (ACM) in men who receive brachytherapy for localized prostate cancer. Therefore, the objective of the current study was to examine the effect of NHT on the risk of ACM in men with prostate cancer who receive with brachytherapy.
The study cohort included 2474 men with localized prostate cancer who either received NHT (N = 1083) or did not receive NHT (N = 1391) and brachytherapy without supplemental external beam radiation between 1991 and 2005 at centers within the 21st Century Oncology Consortium. All men had at least 2 years of follow-up. Low-risk, intermediate-risk, and high-risk disease was present in 65%, 23%, and 12% of men, respectively. A Cox regression multivariate analysis was used to evaluate the risk of ACM in men who received NHT compared with all others adjusting for age, prostate-specific antigen level, Gleason score, and tumor classification.
After a median follow-up of 4.8 years (interquartile range, 3.3-7.5 years) and adjusting for known prostate cancer prognostic factors and age, treatment with NHT was associated significantly with an increased risk of ACM (adjusted hazard ratio, 1.24; 95% confidence interval, 1.01-1.53; P = .04) in men aged ≥73 years. In men who were younger than the median age of 73 years, hormone therapy use was not significant (P = .34).
Compared with men who were younger than the median age of 73 years, men aged ≥73 years with localized prostate cancer who received brachytherapy and NHT had an increased risk of ACM compared with men who did not receive NHT. Cancer 2010. © 2010 American Cancer Society.