685 OUTCOMES OF RADIOTHERAPY AMONG MEN WITH LOW-RISK LOCALIZED PROSTATE CANCER

Abstract

You have accessJournal of UrologyProstate Cancer: Localized III1 Apr 2012685 OUTCOMES OF RADIOTHERAPY AMONG MEN WITH LOW-RISK LOCALIZED PROSTATE CANCER Grace Lu-Yao, Sung Kim, Dirk Moore, Weichung Shih, Yong Lin, Robert DiPaola, Anthony Zietman, Hui Li, Yu-Hsuan Shao, and Siu-Long Yao Grace Lu-YaoGrace Lu-Yao New Brunswick, NJ More articles by this author , Sung KimSung Kim New Brunswick, NJ More articles by this author , Dirk MooreDirk Moore New Brunswick, NJ More articles by this author , Weichung ShihWeichung Shih New Brunswick, NJ More articles by this author , Yong LinYong Lin New Brunswick, NJ More articles by this author , Robert DiPaolaRobert DiPaola New Brunswick, NJ More articles by this author , Anthony ZietmanAnthony Zietman Boston, MA More articles by this author , Hui LiHui Li New Brunswick, NJ More articles by this author , Yu-Hsuan ShaoYu-Hsuan Shao New Brunswick, NJ More articles by this author , and Siu-Long YaoSiu-Long Yao New Brunswick, NJ More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.768AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Although radiotherapy is commonly employed for localized prostate cancer, little data exist regarding whether primary radiotherapy lowers the risk of mortality, metastases, or usage of secondary androgen deprivation therapy (ADT). METHODS A population-based cohort study was performed using Medicare data linked to Surveillance, Epidemiology, and End Results cancer data to evaluate outcomes in 56,657 men aged 65-85 years treated with either primary radiotherapy or surveillance for T1-T2 prostate cancer diagnosed in 1992-2007. Instrumental variable analysis (IVA), a pseudo-randomization technique that captures the randomness associated with geographic variation in the use of radiotherapy was utilized to control for overt and hidden confounders. Secondary ADT was defined as the use of ADT beyond 3 years of cancer diagnosis. RESULTS Radiotherapy use was common among low-risk patients and there was wide geographic variation in utilization. For low-risk group, 10-year disease specific mortality in high- and low radiotherapy areas is identical (5.7% vs. 5.7%; hazard ratio [HR] =1.00; 95% CI 0.82-1.22) and the overall mortality is higher in high-radiotherapy areas (HR=1.06, 95% CI 1.02 – 1.11). In addition radiotherapy was not associated with a lower 10-year risk of secondary ADT use (23.2% in high-use areas, 22.5% in low-use areas at 10-year, HR=1.04, 95% C.I. 0.89-1.20) or metastasis (15.1% in high-use areas, 12.8% in low-use areas at 10-year, HR=1.20, 95% CI 0.97-1.49). CONCLUSIONS In patients aged 65-85 years with low-risk prostate cancer, primary radiotherapy does not reduce mortality, secondary ADT use, or metastases. The potential risks and benefits of radiotherapy and other therapies should be considered when making treatment decisions for localized prostate cancer. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e279 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Grace Lu-Yao New Brunswick, NJ More articles by this author Sung Kim New Brunswick, NJ More articles by this author Dirk Moore New Brunswick, NJ More articles by this author Weichung Shih New Brunswick, NJ More articles by this author Yong Lin New Brunswick, NJ More articles by this author Robert DiPaola New Brunswick, NJ More articles by this author Anthony Zietman Boston, MA More articles by this author Hui Li New Brunswick, NJ More articles by this author Yu-Hsuan Shao New Brunswick, NJ More articles by this author Siu-Long Yao New Brunswick, NJ More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...