Role of Androgen Deprivation Therapy in Early Salvage Radiation Among Patients With Prostate-Specific Antigen Level of 0.5 or Less

Parekh, Arti; Chen, Ming‐Hui; Graham, Powell L.; Mahal, Brandon A.; Hirsch, Ariel E.; Nakabayashi, Mari; Evan, Carolyn; Kantoff, Philip W.; Martin, Neil E.; Nguyen, Paul L.

doi:10.1016/j.clgc.2014.06.016

Cited by 19 publications

(16 citation statements)

References 9 publications

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“…Studies have shown that adjuvant ADT in combination with salvage radiation for postprostatectomy biochemical failure can improve postsalvage bPFS and metastasis-free survival. 23,24 The present study aims to clarify whether the use of neoadjuvant ADT before salvage Cryoablation can prolong cancer-free survival. We hypothesized that as neoadjuvant ADT showed no benefit before primary whole-gland cryotherapy, 16 the use of ADT after biochemical recurrence will also have little oncologic benefit.…”

Section: Commentmentioning

confidence: 99%

The Effect of Androgen Deprivation Therapy Before Salvage Whole-gland Cryoablation After Primary Radiation Failure in Prostate Cancer Treatment

Ruckle

Schlaifer

et al. 2015

Urology

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Section: Commentmentioning

confidence: 99%

The Effect of Androgen Deprivation Therapy Before Salvage Whole-gland Cryoablation After Primary Radiation Failure in Prostate Cancer Treatment

Ruckle

Schlaifer

et al. 2015

Urology

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“…Increased cardiovascular risk is noted in patients with prostate cancer treated with androgen deprivation therapy (ADT) in the form of gonadotropin‐releasing hormone (GnRH) agonists . A 25% increased risk of cardiovascular events was reported for women receiving aromatase inhibitors (anastrozole, letrozole, exemestane) .…”

Section: Mechanisms Of Vascular Toxicities In Cancer Patientsmentioning

confidence: 99%

SCAI Expert consensus statement: Evaluation, management, and special considerations of cardio‐oncology patients in the cardiac catheterization laboratory (endorsed by the cardiological society of india, and sociedad Latino Americana de Cardiologıa intervencionista)

Iliescu

Grines

Herrmann

et al. 2016

Cathet Cardio Intervent

180

135

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In the United States alone, there are currently approximately 14.5 million cancer survivors, and this number is expected to increase to 20 million by 2020. Cancer therapies can cause significant injury to the vasculature, resulting in angina, acute coronary syndromes (ACS), stroke, critical limb ischemia, arrhythmias, and heart failure, independently from the direct myocardial or pericardial damage from the malignancy itself. Consequently, the need for invasive evaluation and management in the cardiac catheterization laboratory (CCL) for such patients has been increasing. In recognition of the need for a document on special considerations for cancer patients in the CCL, the Society for Cardiovascular Angiography and Interventions (SCAI) commissioned a consensus group to provide recommendations based on the published medical literature and on the expertise of operators with accumulated experience in the cardiac catheterization of cancer patients. © 2016 Wiley Periodicals, Inc.

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“…28 Even in the era of ultra-sensitive PSA assays, patients salvaged early (PSA < 0.5) and with negative margins seem to benefit from the addition of ADT. 29 These results, in addition to the ongoing SPPORT (NCT00567580) and RADICALS (NCT00541047) trials will hopefully clarify the role of ADT in the adjuvant or salvage setting. The use of ADT in our cohort was low (22%) and although there was a trend towards improved BCR, no significant association was found (P = 0.15).…”

Section: Androgen Deprivationmentioning

confidence: 86%

“…It has recently been shown that the use of 24 months of concurrent and adjuvant bicalutamide in high risk salvage patients improved overall survival and reduced incidence of metastatic disease 28. Even in the era of ultra‐sensitive PSA assays, patients salvaged early (PSA < 0.5) and with negative margins seem to benefit from the addition of ADT 29. These results, in addition to the ongoing SPPORT (NCT00567580) and RADICALS (NCT00541047) trials will hopefully clarify the role of ADT in the adjuvant or salvage setting.…”

Section: Discussionmentioning

confidence: 99%

Outcomes of post‐prostatectomy radiotherapy at a Regional Cancer Centre

Nicholls

Winter

Harwood

et al. 2017

J of Medical Radiation Sci

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IntroductionTo investigate the efficacy and toxicity of radiation therapy (RT) after radical prostatectomy (RP) for prostate cancer at Radiation Oncology Centres, Toowoomba.MethodsThe electronic medical records of 130 consecutive patients with histologically proven prostate adenocarcinoma who underwent post‐prostatectomy RT between January 2008 and December 2014 were analysed. Primary endpoint was Biochemical Recurrence (BCR) after RT. BCR was defined by PSA > 0.2 ng/mL and BCR endpoints were analysed using Kaplan–Meier methods. The impact of RT technique and the rates of acute and late toxicities are also reported. Toxicities were graded according to Radiation Therapy Oncology Group (RTOG) criteria.ResultsMedian follow‐up time after RT (regardless of technique) was 28 months. BCR occurred in 32 of the 126 patients (25%) whose prostate specific antigen (PSA) levels have been monitored post‐RT. At 24 and 36 months, 85% and 75% of patients were BCR‐free, respectively. Patients with a pre‐RT PSA above 0.2 ng/mL had a higher probability of recurrence than patients with values below 0.2 ng/mL (P = 0.03). RT technique, pelvic nodal irradiation, androgen deprivation therapy, T staging or surgical margin did not significantly impact BCR results.No patient experienced acute toxicities greater than grade 2. Grade 1 or 2 late gastrointestinal (GI) toxicity occurred in 11% and 1 patient experienced a grade 3 event. 12% of patients developed grade 1 or 2 late genitourinary (GU) toxicity, with evidence of grade 3 severity in only 1 patient. Evidence of a trend in reduction in late GI toxicity with the use of intensity modulated radiation therapy (IMRT) or volumetric modulated arc therapy (VMAT) was apparent but not with late GU toxicity.ConclusionAt our regional centre, early RT (PSA < 0.2 ng/mL) was associated with significant improvement in BCR‐free survival. Rates of toxicity mirror those of landmark trials which suggest no detriment for our regional prostate cancer patients. The use of IMRT/VMAT techniques was associated with a trend towards reduced rates of GI toxicity.

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Role of Androgen Deprivation Therapy in Early Salvage Radiation Among Patients With Prostate-Specific Antigen Level of 0.5 or Less

Cited by 19 publications

References 9 publications

The Effect of Androgen Deprivation Therapy Before Salvage Whole-gland Cryoablation After Primary Radiation Failure in Prostate Cancer Treatment

The Effect of Androgen Deprivation Therapy Before Salvage Whole-gland Cryoablation After Primary Radiation Failure in Prostate Cancer Treatment

SCAI Expert consensus statement: Evaluation, management, and special considerations of cardio‐oncology patients in the cardiac catheterization laboratory (endorsed by the cardiological society of india, and sociedad Latino Americana de Cardiologıa intervencionista)

Outcomes of post‐prostatectomy radiotherapy at a Regional Cancer Centre

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