Influence of Timing Between Androgen Deprivation Therapy and External Beam Radiation Therapy in Patients With Localized, High-Risk Prostate Cancer

Neal S. McCall, MD; Yuan Liu, PhD; Sagar A. Patel, MD; Bruce Hershatter, MD; Drew Moghanaki, MD; Karen D. Godette, MD; Sheela Hanasoge, MD, PhD; Pretesh Patel, MD; Benjamin W. Fischer-Valuck, MD; Joseph W. Shelton, MD; Ashesh B. Jani, MD

Advances in Radiation Oncology (Nov 2021)

Influence of Timing Between Androgen Deprivation Therapy and External Beam Radiation Therapy in Patients With Localized, High-Risk Prostate Cancer

Neal S. McCall, MD,
Yuan Liu, PhD,
Sagar A. Patel, MD,
Bruce Hershatter, MD,
Drew Moghanaki, MD,
Karen D. Godette, MD,
Sheela Hanasoge, MD, PhD,
Pretesh Patel, MD,
Benjamin W. Fischer-Valuck, MD,
Joseph W. Shelton, MD,
Ashesh B. Jani, MD

Affiliations

Neal S. McCall, MD: Department of Radiation Oncology, Winship Cancer Institute of Emory University, Atlanta, Georgia; Corresponding author: Neal S. McCall, MD
Yuan Liu, PhD: Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, Georgia
Sagar A. Patel, MD: Department of Radiation Oncology, Winship Cancer Institute of Emory University, Atlanta, Georgia
Bruce Hershatter, MD: Department of Radiation Oncology, Winship Cancer Institute of Emory University, Atlanta, Georgia
Drew Moghanaki, MD: Department of Radiation Oncology, Winship Cancer Institute of Emory University, Atlanta, Georgia
Karen D. Godette, MD: Department of Radiation Oncology, Winship Cancer Institute of Emory University, Atlanta, Georgia
Sheela Hanasoge, MD, PhD: Department of Radiation Oncology, Winship Cancer Institute of Emory University, Atlanta, Georgia
Pretesh Patel, MD: Department of Radiation Oncology, Winship Cancer Institute of Emory University, Atlanta, Georgia
Benjamin W. Fischer-Valuck, MD: Department of Radiation Oncology, Winship Cancer Institute of Emory University, Atlanta, Georgia
Joseph W. Shelton, MD: Department of Radiation Oncology, Winship Cancer Institute of Emory University, Atlanta, Georgia
Ashesh B. Jani, MD: Department of Radiation Oncology, Winship Cancer Institute of Emory University, Atlanta, Georgia

Journal volume & issue: Vol. 6, no. 6
p. 100803

Abstract

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Purpose: Treatment with long-term androgen deprivation therapy (ADT) and radiation therapy (RT) is the nonsurgical standard-of-care for patients with high- or very high-risk prostate cancer (HR-PC), but the optimal timing between ADT and RT initiation is unknown. We evaluate the influence of timing between ADT and RT on outcomes in patients with HR-PC using a large national cancer database. Methods and Materials: Data for patients with clinical T1-T4 N0, M0, National Cancer Comprehensive Network HR-PC who were treated with definitive external RT (≥60 Gy) and ADT starting either before or within 14 days after RT start were extracted from the National Cancer Database (2004-2015). Patients were grouped on the basis of ADT initiation: (1) >11 weeks before RT, (2) 8 to 11weeks before RT, and (3) 11 weeks of neoadjuvant ADT, 11,456 (30.5%) with 8 to 11 weeks of neoadjuvant ADT; and 12,804 (34%) patients with 11 weeks, 8 to 11 weeks, and 11 weeks group. Conclusions: Neoadjuvant ADT initiation 8 to 11 weeks before RT is associated with significantly improved OS compared with shorter neoadjuvant ADT duration. Although prospective validation is warranted, this analysis is the largest retrospective study suggesting an influence of timing between ADT and RT initiation in HR-PC.

Published in Advances in Radiation Oncology

ISSN: 2452-1094 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Medicine (General): Medical physics. Medical radiology. Nuclear medicine; Medicine: Internal medicine: Neoplasms. Tumors. Oncology. Including cancer and carcinogens
Website: http://www.journals.elsevier.com/advances-in-radiation-oncology/

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