University of California, San Francisco CA, USA.
Peter MacCallum Cancer Centre, Melbourne VIC, Australia.
Prostate Cancer Prostatic Dis. 2019 Mar;22(1):117-124. doi: 10.1038/s41391-018-0084-3. Epub 2018 Aug 31.
Androgen deprivation therapy (ADT) has been shown to improve survival for men with intermediate and high-risk prostate cancer undergoing external-beam radiation therapy (EBRT). Using data from a community-based prospective disease registry, we investigated usage of EBRT with or without neoadjuvant ADT.
The CaPSURE database contains 14,863 men with prostate cancer, including 1337 men diagnosed between 1990 and 2014 with localized disease who received EBRT as primary treatment. Prostate cancer risk was calculated using the CAPRA score. Patient characteristics were compared using the Mantel-Haenszel chi-square test for trend and analysis of variance.
Between 1990 and 2014, 14,010 men were diagnosed with localized disease within the CaPSURE registry. Of those, 1337 underwent EBRT. Patients had a median age of 71 years. The use of ADT in addition to EBRT increased from 24% in 1990 to 60% in 1996 with a decrease seen to 47% in 2011. Men receiving ADT have differing clinical characteristics including higher PSA at diagnosis, higher Gleason grade, and higher CAPRA scores. Median ADT duration was 4 months.
The use of ADT in conjunction with primary EBRT has increased in frequency and duration since 1990. Men receiving ADT have higher risk characteristics than those receiving EBRT alone. There is substantial variability in use of ADT in clinical practice.
雄激素剥夺疗法（ADT）已被证明可改善接受外束放射治疗（EBRT）的中高危前列腺癌男性的生存。利用基于社区的前瞻性疾病登记处的数据，我们调查了是否使用 EBRT 联合或不联合新辅助 ADT。
CaPSURE 数据库包含 14863 名前列腺癌患者，其中 1337 名患者于 1990 年至 2014 年期间被诊断为局限性疾病，接受 EBRT 作为主要治疗。使用 CAPRA 评分计算前列腺癌风险。使用 Mantel-Haenszel 卡方检验进行趋势检验和方差分析比较患者特征。
1990 年至 2014 年期间，CaPSURE 登记处有 14010 名患者被诊断为局限性疾病。其中，1337 名患者接受了 EBRT。患者的中位年龄为 71 岁。ADT 联合 EBRT 的使用从 1990 年的 24%增加到 1996 年的 60%，然后在 2011 年降至 47%。接受 ADT 的患者具有不同的临床特征，包括诊断时更高的 PSA、更高的 Gleason 分级和更高的 CAPRA 评分。ADT 的中位持续时间为 4 个月。
自 1990 年以来，ADT 联合 EBRT 的使用频率和持续时间有所增加。接受 ADT 的患者比单独接受 EBRT 的患者具有更高的风险特征。在临床实践中，ADT 的使用存在很大的差异。
