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01-04-2015 | Original Article

Additional androgen deprivation makes the difference

Biochemical recurrence-free survival in prostate cancer patients after HDR brachytherapy and external beam radiotherapy

Authors: Jonas Schiffmann, MD, Hans Lesmana, Pierre Tennstedt, Burkhard Beyer, Katharina Boehm, Volker Platz, Derya Tilki, Georg Salomon, Cordula Petersen, Andreas Krüll, Markus Graefen, Rudolf Schwarz

Published in: Strahlentherapie und Onkologie | Issue 4/2015

Abstract

Background

The role of additional androgen deprivation therapy (ADT) in prostate cancer (PCa) patients treated with combined HDR brachytherapy (HDR-BT) and external beam radiotherapy (EBRT) is still unknown.

Patients and methods

Consecutive PCa patients classified as D’Amico intermediate and high-risk who underwent HDR-BT and EBRT treatment ± ADT at our institution between January 1999 and February 2009 were assessed. Multivariable Cox regression models predicting biochemical recurrence (BCR) were performed. BCR-free survival was assessed with Kaplan–Meier analyses.

Results

Overall, 392 patients were assessable. Of these, 221 (56.4 %) underwent trimodality (HDR-BT and EBRT and ADT) and 171 (43.6 %) bimodality (HDR-BT and EBRT) treatment. Additional ADT administration reduced the risk of BCR (HR: 0.4, 95 % CI: 0.3–0.7, p < 0.001). D’Amico high-risk patients had superior BCR-free survival when additional ADT was administered (log-rank p < 0.001). No significant difference for BCR-free survival was recorded when additional ADT was administered to D’Amico intermediate-risk patients (log-rank p = 0.2).

Conclusions

Additional ADT administration improves biochemical control in D’Amico high-risk patients when HDR-BT and EBRT are combined. Physicians should consider the oncological benefit of ADT administration for these patients during the decision-making process.

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Title: Additional androgen deprivation makes the difference
Biochemical recurrence-free survival in prostate cancer patients after HDR brachytherapy and external beam radiotherapy
Authors: Jonas Schiffmann, MD
Hans Lesmana
Pierre Tennstedt
Burkhard Beyer
Katharina Boehm
Volker Platz
Derya Tilki
Georg Salomon
Cordula Petersen
Andreas Krüll
Markus Graefen
Rudolf Schwarz
Publication date: 01-04-2015
Publisher: Springer Berlin Heidelberg
Published in: Strahlentherapie und Onkologie / Issue 4/2015
Print ISSN: 0179-7158
Electronic ISSN: 1439-099X
DOI: https://doi.org/10.1007/s00066-014-0794-y

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Springer Medicine

Additional androgen deprivation makes the difference

Biochemical recurrence-free survival in prostate cancer patients after HDR brachytherapy and external beam radiotherapy

Abstract

Background

Patients and methods

Results

Conclusions

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Abstract

Background

Patients and methods

Results

Conclusions

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