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• W2331898322 abstract "You have accessJournal of UrologyScience & Technology Posters1 Apr 2016S&T-25 ANDROGEN DEPRIVATION THERAPY IN THE CONTEXT OF DOSE ESCALATING RADIATION: COMMUNITY PRACTICE PATTERNS AND OUTCOMES Bogdana Schmidt, Janet L Cowan, Kirsten L Greene, Peter R Carroll, and Matthew R Cooperberg Bogdana SchmidtBogdana Schmidt More articles by this author , Janet L CowanJanet L Cowan More articles by this author , Kirsten L GreeneKirsten L Greene More articles by this author , Peter R CarrollPeter R Carroll More articles by this author , and Matthew R CooperbergMatthew R Cooperberg More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.2854AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The role of Androgen Deprivation Therapy (ADT) has not been explicitly evaluated in the context of dose escalated external beam radiation therapy (EBRT). While benefits of ADT have shown improved survival for men with intermediate- to high-risk prostate cancer undergoing external beam radiation treatment (EBRT), contemporary trends in practice and outcomes in the community setting have not been well described. METHODS Using the Cancer of the Prostate Strategic Urologic Research Endeavor (CaPSURE) registry we evaluated 1,337 men diagnosed with prostate cancer between 1990 and 2014 who received primary treatment with EBRT. Patient characteristics were compared across year categories using the Mantel-Haenzel chi-square test for trend and analysis of variance (ANOVA). Patients were divided into cohorts by year of diagnosis to assess practice patterns, clinical progression, and survival over time. In addition, patients who received EBRT with subsequent ADT were compared to those receiving EBRT alone. We conducted time-to-event analysis using life tables, log-rank test, Cox proportional hazards regression and competing risk regression models. We evaluated biochemical recurrence (PSA nadir + 2.0 ng/ml), bone metastasis, prostate cancer specific mortality (PCSM), and all-cause mortality (ACM). RESULTS The percentage of patients receiving ADT in addition to EBRT as their primary treatment for prostate cancer has increased from 42% in 1990-1999 to 54% in 2003-2005 and decreased back to 45% in 2006-2014 (p=0.12). Of the patients receiving EBRT+ADT, the percentage of patients receiving greater than six months of ADT has increased from 12% to 20% in this time period (p<0.01). Among patients with high CAPRA risk scores, the use of ADT has significantly increased over time (p<0.01). Treatment type was not associated with recurrence-free survival among all CAPRA risk groups (log-rank p=0.62). There was no difference in clinical disease progression, measured by number of patients with bone metastasis and prostate cancer specific mortality between those receiving EBRT alone and EBRT+ADT, among all CAPRA groups. Treatment modality was not associated with clinical progression or overall survival in any clinical risk group. CONCLUSIONS Use of ADT in patients receiving primary EBRT has increased in frequency and duration since 1990. While the trials for high- risk patients strongly suggest benefit of ADT, our study did not demonstrate the translation of these benefits to the community setting. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e318 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Bogdana Schmidt More articles by this author Janet L Cowan More articles by this author Kirsten L Greene More articles by this author Peter R Carroll More articles by this author Matthew R Cooperberg More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ..." @default.
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• W2331898322 title "S&T-25 ANDROGEN DEPRIVATION THERAPY IN THE CONTEXT OF DOSE ESCALATING RADIATION: COMMUNITY PRACTICE PATTERNS AND OUTCOMES" @default.
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