Cigarette smoking during external beam radiation therapy for prostate cancer is associated with an increased risk of prostate cancer-specific mortality and treatment-related toxicity

2015 ◽  
Vol 116 (4) ◽  
pp. 596-603 ◽  
Author(s):  
Emily Steinberger ◽  
Marisa Kollmeier ◽  
Sean McBride ◽  
Caroline Novak ◽  
Xin Pei ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radiation Therapy ◽  
Cigarette Smoking ◽  
External Beam Radiation Therapy ◽  
External Beam Radiation ◽  
External Beam ◽  
Beam Radiation ◽  
Increased Risk ◽  
Specific Mortality ◽  
Cancer Specific Mortality

18-year prostate cancer-specific mortality after prostatectomy, brachytherapy, external beam radiation therapy, hormonal therapy, or monitoring for localized prostate cancer.

2020 ◽  
Vol 38 (6_suppl) ◽  
pp. 300-300
Author(s):  
Annika Herlemann ◽  
Janet E. Cowan ◽  
Samuel L. Washington ◽  
Anthony C. Wong ◽  
Jenny M. Broering ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radiation Therapy ◽  
High Risk ◽  
External Beam Radiation Therapy ◽  
External Beam Radiation ◽  
External Beam ◽  
Beam Radiation ◽  
Hazard Ratios ◽  
Specific Mortality ◽  
Cancer Specific Mortality

300 Background: The optimal treatment of localized prostate cancer (PCa) remains controversial. We compared long-term survival among men who underwent radical prostatectomy (RP), brachytherapy (BT), external beam radiation therapy (EBRT), primary androgen deprivation therapy (PADT), or monitoring (AS/WW) for localized PCa. Methods: Within the CaPSURE registry, we analyzed 12,062 men with localized PCa. PCa risk was assessed using the Stephenson preoperative nomogram and the Cancer of the Prostate Risk Assessment (CAPRA) score. Multivariable analyses were performed to compare prostate cancer-specific mortality (PCSM) and all-cause mortality (ACM) by primary treatment, adjusting for age and case-mix. An inverse probability weighted regression adjustment was used to reflect propensity for treatment assignment and any imbalances in censoring. Results: 6,357 men (53%) underwent RP, 1,351 (11%) BT, 1,716 (14%) EBRT, 1,605 (13%) PADT, and 1,033 (9%) AS/WW. During the 18-year follow-up period, 514 men died from PCa. Adjusting for clinical CAPRA score, the hazard ratios for PCSM relative to RP were 1.46 (95% CI, 1.00-2.12, p=0.050) for BT, 1.81 (95% CI, 1.43-2.30, p<0.001) for EBRT, 2.77 (95% CI, 2.18-3.51, p<0.001) for PADT, and 1.81 (95% CI, 1.23-2.66, p=0.003) for AS/WW. The greatest difference in PCSM between treatment modalities was observed for high-risk patients. Adjusting for age, comorbidity, and clinical CAPRA score, the hazard ratios for ACM were 1.46 (95% CI, 1.28-1.67) for BT, 1.38 (95% CI, 1.24-1.54) for EBRT, 1.89 (95% CI, 1.67-2.13) for PADT, and 1.60 (95% CI, 1.39-1.84) for AS/WW compared to RP (all p<0.001). Additional analyses using 100-Stephenson score or Fine-Gray competing risks analysis demonstrated similar results. Conclusions: In a large, prospective cohort of men with localized PCa, after adjustment for age and comorbidity, risk of PCSM and ACM was lowest after RP. Mortality was significantly higher after EBRT and AS/WW, and highest after PADT. RP should be offered as part of the management paradigm for high-risk disease, AS/WW should be preferred for most low-risk PCa.

Predictors of prostate cancer-specific mortality in elderly men with intermediate-risk prostate cancer treated with radiation therapy

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 9543-9543
Author(s):  
A. Nanda ◽  
M. Chen ◽  
B. J. Moran ◽  
M. H. Braccioforte ◽  
D. Dosoretz ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radiation Therapy ◽  
External Beam Radiation ◽  
Intermediate Risk ◽  
Elderly Men ◽  
Beam Radiation ◽  
Increased Risk ◽  
Specific Mortality ◽  
Risk Prostate Cancer ◽  
Cancer Specific Mortality

9543 Background: To identify clinical factors associated with prostate cancer-specific mortality (PCSM), adjusting for co-morbidity, in elderly men with intermediate-risk prostate cancer treated with brachytherapy alone or in conjunction with external beam radiation therapy (EBRT). Methods: The study cohort comprised 1,978 men of median age 71 (interquartile range [IQR], 66–75) years with intermediate-risk prostate cancer (Gleason score 7 with PSA 20 ng/mL or less and tumor category T2c or less). Fine and Gray's multivariable competing risks regression was used to assess whether presence of cardiovascular disease (CVD), age, treatment, year of brachytherapy, PSA level, or tumor category were associated with the risk of PCSM. Results: After a median follow up of 3.2 (IQR, 1.7 - 5.4) years, 15 men were observed to experience PCSM. The presence of CVD was significantly associated with a decreased risk of PCSM (AHR 0.20, 95% CI 0.04 - 0.99, P = 0.05), whereas an increasing PSA level was significantly associated with an increased risk of PCSM (AHR 1.14, 95% CI 1.02 - 1.27, P = 0.02). In the absence of CVD, cumulative incidence estimates of PCSM were higher (P = 0.03) in men with PSA levels above as compared to the median PSA level (7.3 ng/mL) or less; however, in the setting of CVD there was no difference (P = 0.27) in these estimates stratified by the median PSA level (6.9 ng/mL). Conclusions: Detection of intermediate-risk prostate cancer in elderly men without CVD at lower PSA levels is associated with a lower risk of PCSM; this risk reduction is not observed in men with known CVD. [Table: see text] No significant financial relationships to disclose.

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