Underutilization of Androgen Deprivation Therapy with External Beam Radiotherapy in Men with High-grade Prostate Cancer
Underutilization of Androgen Deprivation Therapy with External Beam Radiotherapy in Men with High-grade Prostate Cancer
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DOI：
10.1016/j.euo.2019.01.006
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发表时间：
2021-04-12
影响因子：
8.2
通讯作者：
Kishan, Amar U.
中科院分区：
文献类型：
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作者：
Wang, Chenyang;Raldow, Ann C.;Kishan, Amar U.
多项随机试验显示，在接受确定性外照射放疗（EBRT）的Gleason分级组（GG）4-5（即Gleason评分8-10）前列腺癌（PCa）患者中，长期雄激素剥夺治疗（ADT）具有生存获益。我们利用2008年至2011年完整的监测、流行病学和最终结果（SEER）-Medicarelinked数据库进行了一项基于人群的回顾性研究，提取了诊断为GG 4-5 PCa并接受EBRT伴或不伴ADT的非西班牙裔白色（NHW）和非洲裔美国人（AA）PCa患者。在接受明确EBRT的961例患者中，225例（23.4%）未接受ADT，297例（30.9%）接受1-6个月ADT，313例（32.6）接受7-23个月ADT，126例（13.1%）接受与24个月ADT相似的ADT。在对其他协变量的差异进行逆概率治疗加权平衡后的多项logistic回归分析中，与NHW男性相比，AA男性接受1-6个月ADT的比值仍显著低于NHW男性（比值比0.519 [95%置信区间，0.384-0.700]）。总之，长期ADT未得到充分利用，近90%的GG 4-5 PCa患者接受
Multiple randomized trials have shown a survival benefit to long durations of androgen deprivation therapy (ADT) in patients with Gleason grade group (GG) 4-5 (ie, Gleason score 8-10) prostate cancer (PCa) undergoing definitive external beam radiotherapy (EBRT). We conducted a population-based retrospective study utilizing the complete Surveillance, Epidemiology, and End Results (SEER)-Medicarelinked database from 2008 to 2011, extracting PCa patients of non-Hispanic white (NHW) and African-American (AA) race diagnosed with GG 4-5 PCa who received EBRT with or without concomitant ADT. Of 961 patients receiving definitive EBRT, 225 (23.4%) received no ADT, 297 (30.9%) received 1-6 mo of ADT, 313 (32.6) received 7-23 mo of ADT, and 126 (13.1%) received similar to 24 mo of ADT. On multinomial logistic regression after inverse probability treatment weighting to balance for differences in other covariates, AA men still had significantly lower odds of receiving 1-6 mo of ADT versus no ADT compared with NHW men (odds ratios 0.519 [95% confidence interval, 0.384-0.700]). In conclusion, long-duration ADT is underutilized, with nearly 90% of patients with GG 4-5 PCa receiving