Rebecca Araujo

Urban Health Today

A study presented at the American Society for Radiation Oncology (ASTRO) 2024 Annual Meeting in Washington, DC, investigated the potential survival benefit associated with the addition of androgen deprivation therapy (ADT) to radiation therapy (RT) in older patients with prostate cancer.
Dr. Timothy Dougherty and colleagues from the Fox Chase Cancer Center in Philadelphia, Pennsylvania, compared the risk of mortality among patients with intermediate-risk prostate cancer who were age 60 or older. Overall, 10,168 men received RT plus ADT and 12,396 received RT alone. A larger proportion of men in the RT plus ADT group had Gleason 4+3 disease (43% versus 26% in the RT alone group; P=.01). Patients in the RT plus ADT group also had higher prostate-specific antigen levels (P&lt;.001). Among patients who received ADT, 672 (6.6%) were aged 80 years or older.
The hazard ratio (HR) for death associated with the addition of ADT was 0.90 (95% CI, 0.81–0.99; P=.04) in patients aged 60 to 69 years and 0.98 (95% CI, 0.90 – 1.06; P=.54) in patients aged 70 to 79 years. In patients aged 80 years or older, the HR for mortality was 1.13 (95% CI, 0.97 – 1.32; P=.12).
“Consistent with data from randomized controlled trials, younger men (in our example, ages 60–69) have a decreased risk of death when receiving ADT in concert with dose-escalated radiation therapy,” wrote the authors in summary. “Our results show that the overall survival benefit of ADT decreases in older men with intermediate risk prostate cancer, and highlights that octogenarians—a notoriously under-represented group in clinical trials—may benefit the least from the addition of ADT to dose-escalated radiotherapy.”
Reference 
Dougherty T, Hayes SB, Deng M. <a href="https://www.redjournal.org/article/S0360-3016(24)01929-1/fulltext" target="_blank" rel="noopener">Risk of Death in Octogenarians with Intermediate Risk Prostate Cancer Who Are Treated with Radiation Therapy (RT) Plus Androgen Deprivation Therapy (ADT) Versus Radiation Alone, an NCDB Analysis</a>. Poster #3163. Presented at the 2024 American Society for Radiation Oncology Annual Meeting; September 29-October 2, 2024; Washington DC.

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