Enquête observationnelle, transversale de l’Association française d’urologie (AFU) sur la pratique du traitement hormonal intermittent dans le cancer de la prostate en France

Abstract

To assess clinical practice of intermittent hormone therapy (IHT) among urologists members of the French Association of Urology. Internet-based observational survey evaluating IHT modalities in prostate cancer using questionnaire sent to 941 urologists. Two hundred and sixty nine urologists participated in the survey (response rate 28.6 %) including 90.3 % prescribing IHT. The main reasons for IHT were improvement of quality of life in 94.2 %, clinical tolerance in 73.7 %, decreased costs and oncological equivalence in 44 %. The indications were localized prostate cancer (low risk 22.6 %, intermediate 19.8 %, high 14 %), locally advanced (59.7 %), metastatic (63.4 %), biochemical recurrence after local treatment (prostatectomy 62.1 %, radiotherapy 73.7 %). A PSA <2 ng/mL was considered as the threshold for androgen deprivation therapy break in 70 % of cases regardless of the IHT indication. The PSA threshold selected for the re-initiation of treatment was 4 ng/mL in 37.9 % and 10 ng/mL in 36.6 % of cases. The cycle of IHT was 6 months in 60 % of cases. This survey provided a snapshot of the practice of IHT in France. Even in the absence of level of evidence 1 trials in the literature, most urologists used IHT in their clinical practice, for many indications, especially in case of biochemical recurrence after local treatment. 3.