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Williams: Higher T stage benefits frm long ADT wit radiation


JimmyToowong

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Predictors of androgen deprivation therapy efficacy combined with prostatic irradiation: The central role of tumor stage and radiation dose - Abstract

Monday, 31 May 2010

Peter MacCallum Cancer Centre and University of Melbourne, Melbourne, Australia.

To evaluate the response of clinically localized prostate cancer to various durations of planned androgen deprivation therapy (ADT) and to investigate subgroups predicting response.

Data of 3,666 prostate cancer patients treated with either combined ADT and external beam radiotherapy (EBRT) or EBRT alone at four institutions were examined. ADT consisted of neoadjuvant, concurrent, or adjuvant ADT or combinations of these regimens. The primary endpoint was time to biochemical failure (nadir plus 2 ng/ml), assessed from the end of therapy. Factors predictive for the need for ADT were examined with interaction analyses.

The impact of increasing ADT duration was nonlinear with, on average, 6 months of adjuvant ADT resulting in a reduction of the risk of biochemical failure by 38% (95% confidence interval [CI], 29%-46%), while 12, 24, and 36 months of ADT resulted in a 58% (95% CI, 47%-67%), 66% (95% CI, 55%-75%), and 66% (95% CI, 51%-77%) relative failure reduction, respectively. Patients with higher T stage cancers and those treated with lower radiation doses had a significantly greater benefit for increasing ADT duration (interaction, p = 0.016 and p = 0.007, respectively). Pretreatment prostate-specific antigen values, Gleason score, age, and risk group did not modify the response to ADT.

The known ADT efficacy derived from randomized studies can be generalized to patients with different features, and individual predictions of potential benefit from ADT use and duration may be calculated to aid patient and physician decision making. Tumor stage and radiation dose variations were related to significantly different ADT duration effects. The validity of these predictive factors requires prospective evaluation.

Written by:

Williams S, Buyyonouski M, Kestin L, Duchesne G, Pickles T. Are you the author?

Reference: Int J Radiat Oncol Biol Phys. 2010 May 14. Epub ahead of print.

doi: 10.1016/j.ijrobp.2009.11.044

PubMed Abstract

PMID: 20472361 Forum: Very high risk Title: Williams: Higher T stage benefits from longer ADT with radiation

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

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

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