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Effect of Androgen Deprivation Therapy on Other-Cause of Mortality in Elderly Patients with Clinically Localized Prostate Cancer Treated with Modern Radiotherapy: Is There a Negative Impact?

1
Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajiicho Kawaramachi Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
2
Department of Urology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajiicho Kawaramachi Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
3
Department of Radiation Oncology, National Hospital Organization Osaka National Hospital, 2-1-14, Hoenzaka, Chuo-ku, Osaka 540-0006, Japan
4
Department of Radiation Oncology, Osaka University Graduate School of Medicine, Suita, Osaka 565-0871, Japan
5
Department of Radiology, Ujitakeda Hospital, Uji-City, Kyoto 611-0021, Japan
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2019, 8(3), 338; https://doi.org/10.3390/jcm8030338
Received: 11 February 2019 / Revised: 1 March 2019 / Accepted: 6 March 2019 / Published: 11 March 2019
(This article belongs to the Section Oncology)
The influence of androgen deprivation therapy (ADT) on other-cause of mortality (OCM) was investigated in patients with localized prostate cancer treated with modern high-dose radiotherapy. A retrospective review was conducted on 1125 patients with localized prostate cancer treated with high-dose radiotherapy, including image-guided, intensity-modulated radiotherapy or brachytherapy with a median follow-up of 80.7 months. Overall survival rate was no different between ADT (+) and ADT (−) group in high-, intermediate-, and low-risk groups. OCM was found in 71 patients, consisting of 4% (10/258) in the ADT (−) group and 7% (61/858) in the ADT (+) group (p = 0.0422). The 10-year OCM-free survival rate (OCMFS), if divided by the duration of ADT (ADT naïve (ADT (−)), ADT <2-year, and ADT ≥2-year groups), showed statistical significance, and was 90.7%, 88.2%, and 78.6% (p = 0.0039) for the ADT (−), ADT <2-year, and ADT ≥2-year groups, respectively. In patients aged ≥75 years, 10-year OCMFS for ADT (−), ADT <2-, and ADT ≥2-year groups was 93.5% (at 115.6 months), 85.6%, and 60.7% (p = 0.0189), respectively, whereas it was 90.7%, 89.9%, and 89.0% (p = 0.4716), respectively, in their younger counterparts. In localized prostate cancer patients, treatment with longer ADT for ≥2 years potentially increases the risk of OCM, especially in patients aged ≥75 years. View Full-Text
Keywords: prostate cancer; androgen deprivation therapy; brachytherapy; IG-IMRT; elderly; OCM prostate cancer; androgen deprivation therapy; brachytherapy; IG-IMRT; elderly; OCM
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Yamazaki, H.; Masui, K.; Suzuki, G.; Nakamura, S.; Aibe, N.; Shimizu, D.; Yamada, K.; Okihara, K.; Shiraishi, T.; Kotsuma, T.; Yoshida, K.; Tanaka, E.; Otani, K.; Yoshioka, Y.; Ogawa, K.; Nishikawa, T.; Okabe, H. Effect of Androgen Deprivation Therapy on Other-Cause of Mortality in Elderly Patients with Clinically Localized Prostate Cancer Treated with Modern Radiotherapy: Is There a Negative Impact? J. Clin. Med. 2019, 8, 338.

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