PURPOSE: To describe practice patterns associated with androgen suppression (AS) stratified by disease risk group in patients undergoing external-beam radiotherapy (EBRT) for localized prostate cancer. METHODS AND MATERIALS: We identified 2,184 low-risk, 2,339 intermediate-risk, and 2,897 high-risk patients undergoing EBRT for nonmetastatic prostate cancer diagnosed between January 1, 2004, and December 31, 2005, in the linked Surveillance, Epidemiology, and End Results-Medicare database. We examined the association of patient, clinical, and demographic characteristics with AS use by multivariate logistic regression. RESULTS: The proportions of patients receiving AS for low-risk, intermediate-risk, and high-risk prostate cancer were 32.2%, 56.3%, and 81.5%, respectively. AS use among men in the low-risk disease category varied widely, ranging from 13.6% in Detroit to 47.8% in Kentucky. We observed a significant decline in AS use between 2004 and 2005 within all three disease risk categories. Men aged ≥75 years or with elevated comorbidity levels were more likely to receive AS. CONCLUSION: Our results identified apparent overuse and underuse of AS among men within the low-risk and high-risk disease categories, respectively. These results highlight the need for clinician and patient education regarding the appropriate use of AS. Practice patterns among intermediate-risk patients reflect the clinical heterogeneity of this population and underscore the need for better evidence to guide the treatment of these patients.
PURPOSE: To describe practice patterns associated with androgen suppression (AS) stratified by disease risk group in patients undergoing external-beam radiotherapy (EBRT) for localized prostate cancer. METHODS AND MATERIALS: We identified 2,184 low-risk, 2,339 intermediate-risk, and 2,897 high-risk patients undergoing EBRT for nonmetastatic prostate cancer diagnosed between January 1, 2004, and December 31, 2005, in the linked Surveillance, Epidemiology, and End Results-Medicare database. We examined the association of patient, clinical, and demographic characteristics with AS use by multivariate logistic regression. RESULTS: The proportions of patients receiving AS for low-risk, intermediate-risk, and high-risk prostate cancer were 32.2%, 56.3%, and 81.5%, respectively. AS use among men in the low-risk disease category varied widely, ranging from 13.6% in Detroit to 47.8% in Kentucky. We observed a significant decline in AS use between 2004 and 2005 within all three disease risk categories. Men aged ≥75 years or with elevated comorbidity levels were more likely to receive AS. CONCLUSION: Our results identified apparent overuse and underuse of AS among men within the low-risk and high-risk disease categories, respectively. These results highlight the need for clinician and patient education regarding the appropriate use of AS. Practice patterns among intermediate-risk patients reflect the clinical heterogeneity of this population and underscore the need for better evidence to guide the treatment of these patients.
Authors: Michel Bolla; Laurence Collette; Léo Blank; Padraig Warde; Jean Bernard Dubois; René-Olivier Mirimanoff; Guy Storme; Jacques Bernier; Abraham Kuten; Cora Sternberg; Johan Mattelaer; José Lopez Torecilla; J Rafael Pfeffer; Carmel Lino Cutajar; Alfredo Zurlo; Marianne Pierart Journal: Lancet Date: 2002-07-13 Impact factor: 79.321
Authors: Paul L Nguyen; Ming-Hui Chen; Clair J Beard; W Warren Suh; Andrew A Renshaw; Marian Loffredo; Elizabeth McMahon; Philip W Kantoff; Anthony V D'Amico Journal: Int J Radiat Oncol Biol Phys Date: 2009-10-26 Impact factor: 7.038
Authors: Christine Vogeli; Alexandra E Shields; Todd A Lee; Teresa B Gibson; William D Marder; Kevin B Weiss; David Blumenthal Journal: J Gen Intern Med Date: 2007-12 Impact factor: 5.128
Authors: Shrujal S Baxi; Minal Kale; Salomeh Keyhani; Benjamin R Roman; Annie Yang; Antonio P Derosa; Deborah Korenstein Journal: Med Care Date: 2017-07 Impact factor: 2.983