Increasing use of gonadotropin-releasing hormone agonists for the treatment of localized prostate carcinoma
Increasing use of gonadotropin-releasing hormone agonists for the treatment of localized prostate carcinoma
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DOI：
10.1002/cncr.20955
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发表时间：
2005-04-15
期刊：
影响因子：
6.2
通讯作者：
Goodwin, JS
中科院分区：
文献类型：
--
作者：
Shahinian, VB;Kuo, YF;Goodwin, JS
背景。在疾病的早期阶段，雄激素剥夺疗法在前列腺癌中的作用存在争议。作者研究了在基于人群的肿瘤登记处以促性腺激素释放激素 (GnRH) 激动剂或睾丸切除术形式进行雄激素剥夺的时间趋势和模式。方法。数据来自链接的监测、流行病学和最终结果-医疗保险数据库。总共选择了 100,274 名 1991 年至 1999 年间诊断出患有前列腺癌的男性。主要结果是在诊断的前 6 个月内接受≥1 剂 GnRH 激动剂的男性比例。这是按年份绘制的，并按年龄、年级、阶段以及主要使用与辅助使用进行分层。使用多元逻辑回归来检查局部癌症患者亚组中 GnRH 激动剂使用的预测因素。结果。所有年龄、阶段和年级的 GnRH 激动剂使用量逐年持续增加。即使在 80 岁以上患有局部期和低至中度肿瘤的男性中，主要 GnRH 激动剂的使用在研究期间也有所增加，从 1991 年的 3.7% 增加到 1999 年的 30.9% (P < 0.001)。多变量分析表明，SEER 地理区域之间 GnRH 激动剂的使用存在显着差异。结论。 GnRH 激动剂用于治疗前列腺癌的情况在 20 世纪 90 年代急剧增加。这种增加发生在前列腺癌的所有分期和组织学分级中，并且在 80 岁的患者中最为明显。 (c) 2005 年美国癌症协会。
BACKGROUND. The role of androgen deprivation therapy in prostate carcinoma is controversial in earlier stages of disease. The authors examined the time trends and patterns of use for androgen deprivation in the form of gonadotropin-releasing hormone (GnRH) agonists or orchiectomy, in population-based tumor registries.METHODS. Data were obtained from the linked Surveillance, Epidemiology and End Results-Medicare database. A total of 100,274 men with prostate carcinoma diagnosed from 1991 through 1999 were selected. The main outcome was the proportion of men who received >= 1 dose of a GnRH agonist in the first 6 months of diagnosis. This was plotted by year and stratified for age, grade, stage as well as primary versus adjuvant usage. Multiple logistic regression was used to examine predictors of GnRH agonist use in the subset of patients with localized cancer.RESULTS. There was a consistent increase in GnRH agonist use by year for all ages, stages, and grades. Even in men >= 80 years with localized stage and low to moderate grade tumors, primary GnRH agonist use increased over the study period, from 3.7% in 1991 to 30.9% in 1999 (P < 0.001). The multivariable analysis showed that significant variability in GnRH agonist use existed among SEER geographic regions.CONCLUSIONS. The use of GnRH agonists for prostate carcinoma increased dramatically during the 1990s. This increase occurred across all stages and histologic grades of prostate carcinoma, and was greatest in patients 80 years. (c) 2005 American Cancer Society.