Androgen Suppression & Radiation Vs. Radiation For Prostate Cancer: A Randomized Trial & Analysis Of The Prognostic Significance Of Comorbidity

Main Category: Urology / Nephrology
Also Included In: Prostate / Prostate Cancer;  Cancer / Oncology;  Clinical Trials / Drug Trials
Article Date: 19 Jun 2008 - 1:00 PDT

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ORLANDO, FL (UroToday.com) - These investigators conducted a prospective randomized trial to assess whether survival was prolonged following 6 months of androgen suppression therapy (AST) and radiation therapy (RT) as compared to RT.

Between December, 1995 and April, 2001, 206 men with localized prostate cancer and at least one unfavorable prognostic factor were randomized to receive RT alone or in combination with 6 months of AST. All cause mortality (ACM) estimates stratified by randomized treatment arm and further stratified by the Adult Comorbidity Evaluation-27 comorbidity score, a validated chart-based instrument were compared using a log rank test.

After a median follow-up of 7.6 years, a significant increase in the risk of ACM (HR 1.8) was observed in men randomized to RT as compared to RT and AST. However, the increased risk in ACM appeared to apply only to men randomized to RT with no or minimal comorbidity (HR 4.2). Men randomized to RT with moderate or severe comorbidity did not have an increased risk of ACM. Rather, a decreased risk of ACM that approached statistical significance (HR 0.54) was observed.

They conclude that the addition of 6 months of AST to RT prolongs overall survival in men with localized but unfavorable-risk prostate cancer. However, a significant interaction between comorbid illness and AST exists highlighting the importance of considering comorbidity when determining how best to manage a given individual.

Presented by Anthony V D'Amico, MD, Ming-Hui Chen, MD, Andrew Renshaw, MD, Marian Loffredo, MD, Philip Kantoff, MD, at the Annual Meeting of the American Urological Association (AUA) - May 17 - 22, 2008. Orange County Convention Center - Orlando, Florida, USA.

Reported by UroToday.com Contributing Editor Christopher P. Evans, MD, FACS

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