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Survival Advantage of ADT+RT in Prostate CA Extends to Older Men

Reduced cause-specific, all-cause mortality for older men with locally-advanced, screen-detected disease

MONDAY, Jan. 5, 2015 (HealthDay News) -- Androgen-deprivation therapy with radiotherapy (ADT plus RT) is associated with a survival advantage over ADT alone for older men with locally advanced or screen-detected high-risk prostate cancer, according to a study published online Jan. 5 in the Journal of Clinical Oncology.

Justin E. Bekelman, M.D., from the University of Pennsylvania Perelman School of Medicine in Philadelphia, and colleagues conducted nonrandomized effectiveness studies of ADT plus RT versus ADT in three cohorts of patients diagnosed between 1995 and 2007. The randomized clinical trial (RCT) cohort included men aged 65 to 75 years; the elderly cohort included men aged older than 75 years with locally advanced disease; and the screen-detected cohort included men aged 65 years and older with screen-detected high-risk prostate cancer.

The researchers found that ADT plus RT correlated with reduced cause-specific and all-cause mortality compared with ADT alone in the RCT cohort (propensity score-adjusted hazard ratios, 0.43 and 0.63, respectively). There was no significant difference in effectiveness estimates for the RCT cohort versus those from randomized trials (P > 0.1). ADT plus RT correlated with reduced cause-specific and all-cause mortality in the elderly and screen-detected cohorts. Similar estimates were produced in instrumental variable analyses.

"Older men with locally advanced or screen-detected high-risk prostate cancer who receive ADT alone risk decrements in cause-specific and overall survival," the authors write.

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