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Practice patterns of primary EBRT with and without ADT in prostate cancer treatment

Prostate Cancer and Prostatic Diseases volume 22, pages 117–124 (2019)Cite this article

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Abstract

Background

Androgen deprivation therapy (ADT) has been shown to improve survival for men with intermediate and high-risk prostate cancer undergoing external-beam radiation therapy (EBRT). Using data from a community-based prospective disease registry, we investigated usage of EBRT with or without neoadjuvant ADT.

Methods

The CaPSURE database contains 14,863 men with prostate cancer, including 1337 men diagnosed between 1990 and 2014 with localized disease who received EBRT as primary treatment. Prostate cancer risk was calculated using the CAPRA score. Patient characteristics were compared using the Mantel–Haenszel chi-square test for trend and analysis of variance.

Results

Between 1990 and 2014, 14,010 men were diagnosed with localized disease within the CaPSURE registry. Of those, 1337 underwent EBRT. Patients had a median age of 71 years. The use of ADT in addition to EBRT increased from 24% in 1990 to 60% in 1996 with a decrease seen to 47% in 2011. Men receiving ADT have differing clinical characteristics including higher PSA at diagnosis, higher Gleason grade, and higher CAPRA scores. Median ADT duration was 4 months.

Conclusions

The use of ADT in conjunction with primary EBRT has increased in frequency and duration since 1990. Men receiving ADT have higher risk characteristics than those receiving EBRT alone. There is substantial variability in use of ADT in clinical practice.

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Acknowledgements

CaPSURE is supported in part by an unrestricted educational grant from Abbott Laboratories. This research was also supported in part by the Agency for Healthcare Research and Quality grant 1R01HS019356-01.

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Authors and Affiliations

  1. University of California, San Francisco CA, USA

    Bogdana Schmidt, Janet E. Cowan, Jeanette M. Broering, Kirsten L. Greene, Peter R. Carroll & Matthew R. Cooperberg

  2. Peter MacCallum Cancer Centre, Melbourne VIC, Australia

    Renu S. Eapen

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  1. Bogdana Schmidt
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  2. Renu S. Eapen
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  3. Janet E. Cowan
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  7. Matthew R. Cooperberg
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Correspondence to Matthew R. Cooperberg.

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The authors declare that they have no conflict of interest.

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Schmidt, B., Eapen, R.S., Cowan, J.E. et al. Practice patterns of primary EBRT with and without ADT in prostate cancer treatment. Prostate Cancer Prostatic Dis 22, 117–124 (2019). https://doi.org/10.1038/s41391-018-0084-3

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