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Brachy + EBRT + ADT use varies but used with more younger

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Predictors of the use of supplemental androgen suppression therapy and external beam radiation in men with high-risk prostate cancer undergoing brachytherapy in community practice - Abstract

Wed, 23 March 2011

Harvard Radiation Oncology Program, Boston, MA.

We assessed clinical- and practice-related variables associated with the use of trimodality treatment (androgen suppression therapy, external beam radiation therapy, and brachytherapy) in a community-based cohort of men with high-risk prostate cancer.

The study cohort was composed of 1342 men with a prostate-specific antigen level >20ng/mL, clinical tumor stage T3 or T4, and/or Gleason score 8-10 disease at two community radiation facilities, Chicago Prostate Cancer Center (Chicago PCC) and 21st Century Oncology (21C). Logistic regression multivariable analysis was performed to identify factors associated with trimodality treatment.

Of 1342 men treated from 1991 to 2005, 650 (48%) received trimodality therapy. Factors associated with trimodality use include younger age (adjusted odds ratio [AOR] 0.95, p< 0.0001), increasing prostate-specific antigen (AOR 1.54, p< 0.0001), Gleason score 7 (AOR 2.88, p<0.0001), Gleason score 8-10 (AOR 4.28, p< 0.0001), clinical category T2 (AOR 1.40, p=0.012), clinical category T3 (AOR 4.84, p< 0.0001), and year of brachytherapy (AOR 1.13, p< 0.0001). Patients treated at 21C were 4.6 times more likely to receive trimodality therapy (p< 0.0001) than Chicago PCC. There was a significant interaction between cardiovascular comorbidity status and site (comorbidity×21C, AOR 1.74, p=0.025), indicating that less healthy patients were more likely to receive trimodality treatment at 21C than healthy patients and vice versa at Chicago PCC.

Younger men and those with more aggressive pretreatment clinical factors were more likely to receive trimodality treatment in this community cohort of men with high-risk prostate cancer. Selection for trimodality use varied significantly by site indicating a need for treatment standardization in the community.

Written by:

Hattangadi JA, Chen MH, Braccioforte MH, Moran BJ, D'Amico AV.

Reference: Brachytherapy. 2011 Feb 23. Epub ahead of print.

doi: 10.1016/j.brachy.2011.01.004

PubMed Abstract

PMID: 21349778 Forum: Other prostate cancer topics including radiation Title: Brachy + EBRT + ADT use varies but used with more younger and higher risk men

This extract can be found on http://PubMed.com, and is in the public domain.

On PubMed.com there will be a link to the full paper (often $30, sometimes free).

Any highlighting (except the title) is not by the author, but by Jim Marshall.

Jim is not a doctor.

This page was found on the Advanced Prostate Cancer Community for Australian men at http://advancedprost...lia.ipbhost.com.

The link is hard to remember.

An easier way to find it is to go to JimJimJimJim.com and click on Prostate.

That's the word Jim four times, no spaces, followed by .com.

If you need other help - to perhaps find someone to talk to or a local support group:

Click on the Contact Jim button at http://JimJimJimJim.com.

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