Survival benefit associated with adjuvant androgen deprivation therapy combined with radiotherapy for high- and low-risk patients with nonmetastatic prostate cancer

Steven B. Zeliadt, Arnold L. Potosky, David F. Penson, Ruth Etzioni

Research output: Contribution to journalArticle

33 Scopus citations

Abstract

Background: The use of adjuvant androgen deprivation therapy (ADT) combined with radiotherapy has become common in low-risk patients, although clinical trials have focused primarily on high-risk patients. This study examines the effectiveness of adjuvant ADT combined with radiotherapy for a wide range of patients treated in the 1990s. Methods and Materials: Prostate cancer survival was examined in a population based cohort of 31,643 patients aged 65 to 85 years who were diagnosed with nonmetastatic prostate cancer and treated with external beam radiotherapy and/or brachytherapy. Instrumental variable analysis methods were used to control for selection bias. Results: Patients with stage T3/T4 disease who received adjuvant ADT experienced improved 5-year and 8-year survival. No survival advantage was observed for men with T1/T2 disease during this interval. Conclusion: High-risk patients who receive primary radiotherapy have benefited from adjuvant ADT, whereas low-risk patients with disease confined to the prostate have not yet benefited from adjuvant therapy within the first 8 years after treatment. These findings are consistent with practice guidelines, which recommend adjuvant ADT for patients with high-risk disease.

Original languageEnglish (US)
Pages (from-to)395-402
Number of pages8
JournalInternational Journal of Radiation Oncology Biology Physics
Volume66
Issue number2
DOIs
StatePublished - Oct 1 2006
Externally publishedYes

Keywords

  • Adjuvant androgen deprivation therapy
  • Instrumental variables
  • LHRH agonists
  • Prostate
  • Prostatic neoplasms
  • SEER-Medicare

ASJC Scopus subject areas

  • Radiation
  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Cancer Research

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