You have accessJournal of UrologyGeneral & Epidemiological Trends & Socioeconomics: Evidence-based Medicine & Outcomes II1 Apr 201047 HOW DOES LEVEL I EVIDENCE AFFECT TREATMENT TRENDS OF EBRT+AST COMBINATION THERAPY FOR PROSTATE CANCER? Shaheen Alanee, Stephanie Jarosek, Beth Virnig, and Sean Elliott Shaheen AlaneeShaheen Alanee Columbia Heights, MN More articles by this author , Stephanie JarosekStephanie Jarosek Minneapolis, MN More articles by this author , Beth VirnigBeth Virnig Minneapolis, MN More articles by this author , and Sean ElliottSean Elliott Minneapolis, MN More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.093AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Several studies show the addition of androgen suppression therapy (AST) to external beam radiotherapy (EBRT) improves survival in high risk prostate cancer. We tested the hypothesis that after the publication of trials in 1997 and later, an increased proportion of those treated with primary EBRT for high risk prostate cancer would receive neoadjuvant or adjuvant AST. In contrast, a decreased proportion of those with low risk prostate cancer would receive AST. METHODS 97,940 men ≥66 years, diagnosed with non-metastatic prostate cancer in 1992-2005 and receiving primary treatment with EBRT were identified from the SEER-Medicare database. Patients were classified as high risk if they had cT3 cancer or Gleason Score 8-10. Neo/adjuvant AST was defined as receiving AST any time before or up to 3 months after the completion of EBRT. We defined the crude proportion receiving AST each year. Multivariate logistic regression modeling was then used to define the odds ratio of AST treatment for each year (1993-2005) compared to the baseline in 1992. Separate models were run for low and high risk patients, controlling for the covariates of age, race, income, education, registry, and other comorbidities measured by the Charlson comoribidity index. RESULTS The odds of receiving AST, given EBRT increased in 1993-1999, plateaued in 1999-2003 and declined thereafter. The same general trend was seen in high and low risk patients, although the curves diverged over time. Older age and increased comorbidity were associated with higher odds for receiving AST. CONCLUSIONS The practice of adding AST to EBRT was not positively affected by the publication of supporting level I evidence. 60% of high risk patients in 2005 were not receiving neo/adjuvant AST with their EBRT. Discretionary AST use follows the same general trends as indicated AST use but with a slightly sharper decline over time. © 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e20 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Shaheen Alanee Columbia Heights, MN More articles by this author Stephanie Jarosek Minneapolis, MN More articles by this author Beth Virnig Minneapolis, MN More articles by this author Sean Elliott Minneapolis, MN More articles by this author Expand All Advertisement Advertisement Loading ...