Increasing use of gonadotropin-releasing hormone agonists for the treatment of localized prostate carcinoma
TLDR
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.Abstract:
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. Cancer 2005. © 2005 American Cancer Society.read more
Citations
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Diabetes and Cardiovascular Disease During Androgen Deprivation Therapy: Observational Study of Veterans With Prostate Cancer
TL;DR: Androgen deprivation therapy with GnRH agonists was associated with an increased risk of diabetes and cardiovascular disease and oral antiandrogen monotherapy was not associated with any outcome studied.
References
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Quality-of-life outcomes after primary androgen deprivation therapy: results from the Prostate Cancer Outcomes Study.
Arnold L. Potosky,Kevin B. Knopf,Limin X. Clegg,Peter C. Albertsen,Janet L. Stanford,Ann S. Hamilton,Frank D. Gilliland,J. William Eley,Robert A. Stephenson,Richard M. Hoffman +9 more
TL;DR: Most endocrine-related health outcomes are similar after surgical versus medical primary hormonal therapy, and these results provide representative information comparing surgical and medical AD therapy that may be used by physicians and patients to inform treatment decisions.
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Combined orchiectomy and external radiotherapy versus radiotherapy alone for nonmetastatic prostate cancer with or without pelvic lymph node involvement: a prospective randomized study
TL;DR: The results strongly suggest that early androgen deprivation is better than deferred endocrine treatment for patients with prostate cancer and pelvic lymph node involvement and overall survival rates are significantly better after combined androgen ablation and radiotherapy than after radiotherapy alone.