Does concomitant anti-androgen therapy improve outcomes in patients with recurrent prostate cancer undergoing early salvage radiation therapy
Sood A, Keeley J, Dalela D, Arora S, Palma-Zamora I, Jamil M, Kovacevic N, Jeong W, Trinh QD, Rogers CG, Peabody JO, Menon M, and Abdollah F. Does concomitant anti-androgen therapy improve outcomes in patients with recurrent prostate cancer undergoing early salvage radiation therapy. European Urology Open Science 2020; 19:e1062.
European Urology Open Science
Introduction & Objectives: To examine whether addition of anti-androgen therapy (AAT) to ‘early’ salvage radiation therapy (sRT) improves outcomes in men with recurrent prostate cancer after radical prostatectomy.
Materials & Methods: Data on 394 men who participated in the RTOG 9601 trial and experienced biochemical recurrence were extracted using the NCTN data archive platform. Patients were stratified into two treatment groups: early sRT (pre-sRT PSA <0.7ng/mL) with and without concomitant AAT, based on the cut-offs reported in the original trial. Cox proportional hazards and Fine-Gray competing-risk regression analyses assessed the adjusted hazards of overall mortality, CaP specific mortality and metastatic/local disease progression among the two treatment groups.
Results: Patients were well-matched in baseline characteristics. The median follow-up was 12 years. At 10-years, for patients treated with early sRT and early sRT with AAT, the overall mortality, CaP specific mortality and metastasis rates were 14% vs. 16%, and 7% vs. 3%, and 12% vs. 9%, respectively. Adjusted analysis demonstrated improvement in hazards of CaP specific mortality (HR 0.44, p<0.05), but hazards of overall mortality remained the same (HR 0.99, p>0.05, Table), in patients undergoing concomitant AAT vs. not along with early sRT.
Conclusions: Benefit of concomitant AAT in patients undergoing early sRT is questionable.