775 INTERMITTENT ANDROGEN DEPRIVATION THERAPY: DURATION OF THE FIRST OFF TREATMENT INTERVAL AS A PREDICTOR OF DISEASE PROGRESSION AND PROSTATE CANCER DEATH

Abstract

You have accessJournal of UrologyProstate Cancer: Advanced II1 Apr 2012775 INTERMITTENT ANDROGEN DEPRIVATION THERAPY: DURATION OF THE FIRST OFF TREATMENT INTERVAL AS A PREDICTOR OF DISEASE PROGRESSION AND PROSTATE CANCER DEATH Rafael Sanchez-Salas, Dominique Prapotnich, Fernando Secin, Marc Galiano, Francois Rozet, Eric Barret, and Xavier Cathelineau Rafael Sanchez-SalasRafael Sanchez-Salas Paris, France More articles by this author , Dominique PrapotnichDominique Prapotnich Paris, France More articles by this author , Fernando SecinFernando Secin Buenos Aires, Argentina More articles by this author , Marc GalianoMarc Galiano Paris, France More articles by this author , Francois RozetFrancois Rozet Paris, France More articles by this author , Eric BarretEric Barret Paris, France More articles by this author , and Xavier CathelineauXavier Cathelineau Paris, France More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.862AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES To analyze the association between duration of first OFF treatment interval and time to cancer specific death in prostate cancer patients who experienced biochemical recurrence (BCR) after radical prostatectomy, or radiation therapyand were treated with intermittent androgen deprivation (IAD) therapy. METHODS We identified 158 patients who were treated with IAD therapy after BCR following prostatectomy, or external beam radiation treatment at our institution between 1992 and 2011. On-treatment period (ONTP) consisted of three-monthly injections of gonadatropin-releasing hormone (GnRH) agonist combined with daily oral androgen receptor antagonist. Off-treatment period (OFTP) was indicated when PSA was < 4 ng/ml. Criteria for resumption of hormonal therapy were PSA >20 ng/ml or clinical symptoms. Kaplan Meier curves with Uni and multivariate Cox regression model was used to identify variables associated with cancer specific survival. RESULTS Median (Percentile 25-75) age was 65 years (61-69). 110 patients were primarily treated with prostatectomy, 20 of these received salvage radiation therapy; 48 were initially treated with external beam radiation. Gleason score was <6 in 75 patients (47.4%), 7 in 61(38.6%) and 8 in 22 (13.9%) men. Median PSA at initial IAD was 9.8 ng/ml (5-20). Median duration of the first off treatment interval was 46 months (27-74) Median time from local treatment to start of IAD was 29.2 months (Range: 2-52). During a median follow-up of 7.2 years (5-10) since start of IAD, 50 patients died of disease and 18 patients died of other cause. 10-year cancer specific survival since start of IAD was 57% (95%CI: 46-66) and the corresponding overall survival was 48% (38-57) After adjusting for primary therapy, age and serum PSA at the start of IAD, presence of Gleason score 8-10, and shorter duration of the first off treatment interval after start of IAD were significantly associated with worse cancer specific survival. CONCLUSIONS Shorter duration of first OFF treatment interval after start of IAD and higher Gleason score were significantly associated with worse cancer specific survival in prostate cancer patients who experienced BCR after radical prostatectomy or external beam radiation therapy. Variable HR P value (95% Conf. Interv.) Prostatectomy alone (Reference) Prostatectomy+Radiation 1.7 0.3 0.7 4.2 Radiation 1.9 0.06 0.97 3.6 Age 0.96 0.1 0.91 1.01 PSA at start of IAD 1.01 0.3 0.99 1.02 Gleason 8-10 2.24 0.01 1.2 4.3 Duration of first OFF treatment 0.99 0.008 0.978 0.997 © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e317 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Rafael Sanchez-Salas Paris, France More articles by this author Dominique Prapotnich Paris, France More articles by this author Fernando Secin Buenos Aires, Argentina More articles by this author Marc Galiano Paris, France More articles by this author Francois Rozet Paris, France More articles by this author Eric Barret Paris, France More articles by this author Xavier Cathelineau Paris, France More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...