Article ID | Journal | Published Year | Pages | File Type |
---|---|---|---|---|
5529475 | Radiotherapy and Oncology | 2017 | 5 Pages |
PurposeTo determine whether the survival benefit associated with prolonged androgen deprivation therapy (ADT) and radiotherapy (EBRT) varies with baseline estimates of overall survival in cT3-4 prostate cancer patients (PCa).Methods and materialsIn 1997, the BC Cancer Agency adopted as standard a policy of prolonged ADT (>18 months) with EBRT for locally advanced PCa. Two cohorts of cT3-T4 PCa treated with EBRT were selected: 1993-1995 (early: N = 725) and 1999-2001 (late: N = 584). Duration of ADT and baseline prognostic factors (age, clinical stage, grade, presenting PSA, and Charlson index (CCI)) were abstracted from charts. Estimates of 10-year (E10) survival using an age-adjusted CCI were calculated and patients were grouped into low (<60%), medium (60-90%) and high (>90%) E10. In each E10 group, actual overall survivals were compared by era using log rank test.ResultsThere were 318 low, 544 medium, and 447 high E10 patients with median follow-up of 11.1 years. Gleason grade and T stage were not statistically different between E10 groups. As expected, median age and baseline CCI were higher in lower E10 groups (p < 0.0001). Overall survival was higher in the late era, but varied with E10 group: low (43% vs. 49%, p = 0.54), medium (55% vs. 64%, p = 0.02) and high (66% vs. 77%, p = 0.01).ConclusionThe policy of prolonged ADT with EBRT provides a survival benefit that varies with baseline risk of death from other causes. Absolute benefit from ADT is largest in those with medium or high E10.