The Impact of Hormone Therapy on Overall Survival for Prostate Cancer Patients under Prostatectomy and Salvage Radiation Therapy Open Access

Lyu, Xueying (Spring 2020)

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Salvage radiotherapy (SRT) is one of common treatments to control biochemical recurrence after radical prostatectomy for prostate cancer patients. According to previous study, Salvage radiation therapy (SRT) with short-term hormone therapy is an efficient way to improve overall survival of prostate patients after radical prostatectomy but not equal benefit for all men. It is still unknown who benefits most from hormone therapy.


Patients with demographics, tumor and treatment characteristics information from the National Cancer Data Base (2004-2015) were divided into Radiation therapy only group and Radiation Therapy with Hormone therapy group. Univariate analyses, multivariate analyses (MVAs) and Propensity score (PS) weighting were implemented. The Kaplan‐Meier method was used to describe overall survival for study groups.


There are 1931 patients included in cohort, 1529 (79.2%) took radiation therapy only after surgery whiles 402 (20.8%) took radiation therapy combined with hormone therapy. Compared to patients taking radiation therapy only, patients with radiation therapy and hormone therapy had a larger proportion of white people, with lower income, located in Midwest, more poorly or undifferentiated tumors, a higher proportion of pathologic T3 and in a high risk-group. Radiation with Hormone Therapy was associated with worse overall survival (HR=1.74, 95% CI 1.32‐2.29, P < 0.001). The effect of the treatment group was then further estimated in the weighted sample with a Cox model, which yielded an HR of 1.20 (95% CI, 0.99‐1.46; P = 0.061) for Radiation Therapy with Hormone Therapy versus Radiation Therapy only.


Radiation with Hormone Therapy was associated with worse overall survival in a long-term compared with radiation therapy only. The greatest overall survival benefit from radiation therapy treatment was seen in subgroups of patients with more aggressive prostate cancer, such as those with a higher gleason score (Gleason Score from 8 to 10) and pathologic T‐stage of T3.

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