Radiation Tx Impact Varies With Comorbidity in Prostate Cancer
Reduction in overall, cardiac mortality for RT alone in men with severe or moderate comorbidity
TUESDAY, Sept. 22, 2015 (HealthDay News) -- For men with unfavorable-risk prostate cancer, the impact of radiotherapy (RT) versus RT plus androgen deprivation therapy (ADT) varies with comorbidity, according to a research letter published in the Sept. 22/29 issue of the Journal of the American Medical Association.
Anthony V. D'Amico, M.D., Ph.D., from Brigham and Women's Hospital in Boston, and colleagues used data from a randomized trial to compare overall survival and mortality from prostate cancer, cardiac, or other causes in all men and within subgroups randomized by treatment. Data were included from 206 men with unfavorable-risk prostate cancer who were randomized to receive RT alone or RT and six months of ADT.
The researchers found that 94 percent of men with moderate or severe comorbidity died, compared with 70 percent of those with no or minimal comorbidity. In men with no or minimal comorbidity, RT treatment alone compared with RT and ADT correlated with significantly increased overall mortality (hazard ratio, 1.51) and prostate cancer mortality (hazard ratio, 4.30) in multivariate analyses. For men with moderate or severe comorbidity, RT alone versus RT and ADT correlated with significantly decreased overall mortality and cardiac mortality (hazard ratios, 0.36 and 0.17).
"The association of treatment with RT alone with decreased cardiac and overall mortality in men with moderate or severe comorbidity suggests that administering ADT to treat unfavorable-risk prostate cancer in these men should be carefully considered," the authors write.