Radiation Plus ADT Beneficial in Node-Positive Prostate Cancer

Men receiving radiotherapy plus ADT had a significant 50% decreased risk of 5-year overall mortality compared with men receiving ADT alone.
Men receiving radiotherapy plus ADT had a significant 50% decreased risk of 5-year overall mortality compared with men receiving ADT alone.

ORLANDO, Fla.—Radiation treatment (RT) added to androgen-deprivation therapy (ADT) is associated with a significant survival benefit in patients with clinically node-positive prostate cancer (PCa), according to study findings presented at the 2015 Genitourinary Cancers Symposium.

The study, led by Jason A. Efstathiou, MD, DPhil, of Massachusetts General Hospital in Boston, included 3,540 men diagnosed with primary clinically node-positive PCa without distant metastases from 2004–2011. Of these, 32.2% received ADT alone and 51.4% received RT plus ADT. The remaining patients received RT alone or neither ADT nor RT.

After propensity score matching to adjust for possible selection biases, 318 patients remained in each group. Men receiving RT plus ADT had a significant 50% decreased risk of 5-year overall mortality compared with the men receiving ADT alone.

“These findings, if appropriately validated, suggest that re-evaluation of current practice guidelines may be warranted,” the authors concluded in a poster presentation.

Patients younger than 65 years and those with lower comorbidity scores, higher Gleason scores, lower PSA values, and private insurance were significantly more likely to receive RT plus ADT, Dr. Efstathiou's group reported.

The investigators obtained data from the National Cancer Data Base, a national hospital-based cancer registry jointly sponsored by the American College of Surgeons and the American Cancer Society.

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