ADT plus radiotherapy ups survival in metastatic prostate CA
Chad G. Rusthoven, M.D., from the University of Colorado School of Medicine in Aurora, and colleagues examined the OS of men with mPCa treated with ADT, with and without prostate RT, using data from the National Cancer Database. A total of 6,382 men with mPCa were identified, of whom 8.4 percent received prostate RT.
At a median follow-up of 5.1 years, the researchers found that the addition of prostate RT to ADT correlated with improved OS on univariate analysis (P < 0.001) and multivariate analysis adjusted for confounding variables (hazard ratio, 0.624; P < 0.001). Superior median and five-year OS were seen for RT plus ADT versus ADT alone in propensity score analysis with matched baseline characteristics (P < 0.001). Improved OS was seen with prostate RT in all subsets in landmark analyses limited to long-term survivors of at least one, three, and five years (all P < 0.05). No significant differences were seen in OS in secondary analyses comparing the survival outcomes for patients treated with a therapeutic dose of RT plus ADT versus prostatectomy plus ADT, although both therapies were superior to ADT alone.
"In this large contemporary analysis, men with mPCa receiving prostate RT and ADT lived substantially longer than men treated with ADT alone," the authors write. "Prospective trials evaluating local therapies for mPCa are warranted."
Several authors disclosed financial ties to the biopharmaceutical industry.
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