Prolonged ADT before RT won't cause double time on relapse

[JimmyToowong]

Can J Urol. 2004 Aug;11(4):2316-21.

PSA doubling time post radiation: the effect of neoadjuvant androgen ablation.

Tyldesley S, Coldman A, Pickles T; Prostate Cohort Outcomes Initiative.

Department of Radiation Oncology, British Columbia Cancer Agency, Vancouver, BC, Canada.

Abstract

OBJECTIVE: To determine whether men who relapse after neoadjuvant androgen ablation (NAA) and high-dose radiation therapy (RT) have faster PSA doubling times(PSAdt) than those who are treated with RT alone. MATERIALS AND METHODS: From a prospective database of 1880 patients treated with RT for localized prostate cancer, patients were selected for further study if they had a rising PSA profile >1 ng/ml, and were treated with either no NAA, or prolonged NAA (defined as 3-12 months NAA) with a minimum 5 years follow-up. ThePSAdt was calculated from the exponential line of best fit from the first post-nadir value >1 ng/ml to the last PSA prior to secondary intervention. Those patients with a rising PSA profile at 5 years of follow-up were further examined with linear regression to determine factors of possible independent adverse effect.

RESULTS: There were 251 patients eligible with rising PSA profiles. Patients treated with NAA had higher pre-treatment Gleason scores (pThe use of prolonged NAA in men treated with RT does not itself cause a more rapid PSAdt when relapse occurs. Faster relapse observed in these men is due to intrinsically more aggressive tumors prior to treatment.

PMID: 15460601 Forum: Primary hormone therapy Title: Prolonged ADT before RT does not cause rapid doubling time on relapse

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