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Hormone therapy increased risk for mortality in older men with prostate cancer

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ASTRO 50th Annual Meeting

BOSTON — The results from a retrospective study involving more than 1,700 men with prostate cancer showed that patients aged 70 and older assigned to androgen deprivation therapy were at increased risk for all-cause mortality.

Amy Dosoretz, MD, a resident at the Harvard Radiation Oncology Program, presented the results at the American Society for Therapeutic Radiology and Oncology’s 50th Annual Meeting.

“Older men who are treated by hormone therapy followed by the brachytherapy procedure had a 20% increased risk of dying compared to those men who were treated with the radioactive seed implant alone,” she said in a press briefing.

Researchers in Boston, Fort Myers, Fla. and Storrs, Conn., conducted a retrospective review of 1,709 men aged 70 years and older treated with (n=786) or without (n=916) hormone therapy. The researchers found that, even after adjusting for age and prognostic factors, hormone therapy prior to brachytherapy was still associated with increased risk for all-cause mortality (HR=1.2; 95% CI, 1.0-1.4).

They concluded that younger men did not face the same risk.

“Our message we want to send out, is that, in older patients, it’s very important to weigh the risks and benefits of hormone therapy when designing the treatment plans for these patients,” Dosoretz said. – by Jason Harris

My take on this study is that the use of hormone therapy for prostate cancer as an adjuvant or neoadjuvant with radiation therapy is best reserved at this time for patients who have high-risk disease. In patients with low- and intermediate-risk disease, the use of hormone therapy in those patients should be questioned. Studies like this help to frame the argument that you should hold off on hormone therapy.

– Louis Potters, MD

Chairman, Department of Radiation Medicine
North Shore-Long Island Jewish Health System

For more information:

• Dosoretz AM, Chen MH, Salenius SA, et al. Mortality in men age 70 or more with localized prostate cancer treated with brachytherapy with or without neoadjuvant hormonal therapy. Presented at: the American Society for Therapeutic Radiology and Oncology’s 50th Annual Meeting; Sept. 21-25, 2008; Boston.