Impact of the duration of hormonal therapy following radiotherapy for localized prostate cancer

Okubo, Masaaki; Nakayama, Hidetsugu; Itonaga, Tomohiro; Tajima, Yu; Shiraishi, S.; Mikami, Ryuji; Sakurada, Akira; Sugahara, Shinji; Koizumi, Kiyoshi; Tokuuye, Koichi

doi:10.3892/ol.2015.3216

Cited by 5 publications

(6 citation statements)

References 25 publications

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“…Therefore, we could not draw a conclusion that CVD is more likely to happen in 5 years. The results from Mitsuru et al in terms of a large cohort are similar to ours, and they suggested that the incidence of cardiac events was significantly higher among patients treated with short‐term ADT (<3 year) compared with patients treated with long‐term ADT(>3 year) ( P < .01). In another observational study, Efstathiou et al found no evidence to prove that longer‐term ADT increased cardiovascular mortality compared with short‐term ADT in men with locally advanced PCa.…”

Section: Discussionsupporting

confidence: 83%

Is androgen deprivation therapy for prostate cancer associated with cardiovascular disease? A meta‐analysis and systematic review

et al. 2019

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Background: Androgen deprivation therapy (ADT) is widely being applied in men who suffered from prostate cancer. Whether androgen deprivation therapy (ADT) is associated with an increased risk of developing cardiovascular-related disease is poorly defined. Objectives:The aim of the present meta-analysis is to explore the relationship between ADT and the risk of cardiac events. Materials and methods:For this systematic review and meta-analysis, we searched databases from inception to April 2019 for randomized controlled trials (RCT) or observational studies that reported data on ADT administration and cardiac event incidence. The connection was evaluated through estimating relative risk ratio (RR) and 95% confidence intervals (CIs). Results:A significantly increased acute myocardial infarction (AMI) was detected in the ADT group compared with the control group (RR = 1.19, 95% confidence interval (CI), 1.02-1.39, P < .05). A significant difference between cardiovascular disease (CVD) andADT was also observed, with summary RR = 1.25, 95% CI, 1.11-1.40, P < .05. Furthermore, our study also suggested ADT was not related to increased incidence of sudden cardiac death (SCD) (RR = 1.13, 95% CI, 0.92-1.38, P = .24); AMI and CVD were not connected with the duration of ADT (AMI: RR = 1.31; 95% CI, 0.66-2.63, P = .44, for > 5 year group; CVD: RR = 1.12, 95% CI, 0.97-1.30, P = .12, for > 5 year group). In addition, the RR for risk of CVD was 1.28 (95% CI, 1.01-1.62, P < .05) for men with PCa on new hormonal agents.Discussion: Various ADT modalities have different impact on cardiovascular disease risk in different level. Long-term application of ADT is not associated with increased risk of AMI and CVD. Both abiraterone and enzalutamide could significantly increase the incidence of cardiac events in patients who suffered from prostate cancer. Cautions and periodic cardiovascular elevation are necessary for patients before the ADT starting. Conclusions:Androgen deprivation therapy is associated with increased risk of AMI, CHD, in contrast, this association is not detected in SCD. K E Y W O R D Sandrogen deprivation therapy, cardiovascular disease, prostate cancer

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Section: Discussionsupporting

confidence: 83%

Is androgen deprivation therapy for prostate cancer associated with cardiovascular disease? A meta‐analysis and systematic review

et al. 2019

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“…This supports the opinion that those patients threated with ADT and an preexisting CV disease may be at the greatest risk (2)(3)(4)(5)33). Increased cardiovascular toxicity in patients undergoing a short-term ADT was confi rmed by another authors (38). During long-term agonist therapy the loss of GnRH receptor sensitivity may occur what can be accompanied with renewal of testosterone production (24) and this fact may partially clarify these results.…”

Section: Clinical Studiessupporting

confidence: 63%

Androgen deprivation therapy and cardiovascular complications

Poljak¹,

Hulín²,

Maruscakova³

et al. 2017

BLL

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Cardiovascular complications associated with the use of antiandrogens have already been known for some time. Based on the results of the latest meta-analyses and clinical studies published in the last few years, the attention of the scientifi c community is focused on the deleterious cardiovascular effects of gonadotropine-releasing hormon agonists in context of the androgen deprivating therapy. The cardiac toxicity is a problem especially in patients with preexisting cardiovascular comorbidities. Increased arterial wall thickening along with endothelial dysfunction has been observed in patients with descreased androgens levels in the peripheral blood. The treatment with gonadotropine-releasing hormon agonists may disrupt the intracellular concentration of calcium ions and the contractile process and potentially result in pathological remodelling of heart. Here, we give several possible mechanisms of action of gonadotropine-releasing hormon agonists on the cardiovascular system that may be a potential explanation of the clinical observations (Ref. 44). Text in PDF www.elis.sk.

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“…In another study, significant difference was observed in the 5-year biochemical PFS rates between short- (<36 months) and long-term (≥36 months) ADT (84.0% vs. 96.2%; P=0.04). However, the difference in OS was not significant (86.8% vs. 94.4%; P=0.16) (40). In our study, the majority of the patients (66.6%) received CAB, followed by AA (27.0%) and LHRHa (6.9%) for median 20 months.…”

Section: Discussionmentioning

confidence: 99%

Adjuvant hormone therapy after radical prostatectomy in high-risk localized and locally advanced prostate cancer: First multicenter, observational study in China

Zhang

et al. 2019

Chinese Journal of Cancer Research

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Objective Potential of combined androgen blockade (CAB) has not been explored extensively in Chinese males with prostate cancer (PCa). Therefore, this study evaluated the 2-year prostate-specific antigen (PSA) recurrence rate and quality of life (QoL) in patients with high-risk localized and locally advanced PCa receiving adjuvant hormone therapy (HT) after radical prostatectomy (RP). Methods This prospective, multicenter, observational study conducted in 18 centers across China enrolled patients with high-risk factor (preoperative PSA>20 ng/mL or Gleason score >7) or locally advanced PCa. Different adjuvant HT were administered after RP according to investigator’s decision in routine clinical practice. Relationship of baseline and postoperative characteristics was assessed with recurrence rate. PSA recurrence rate and Functional Assessment of Cancer Therapy-Prostate (FACT-P) QoL scores were recorded at 12 months and 24 months. Kaplan-Meier analysis was used to construct the PSA recurrence rate during follow-up. Results A total of 189 patients (mean age: 66.9±6.5 years) were recruited, among which 112 (59.3%) patients showed serum PSA>20 ng/mL preoperatively. The highest postoperative pathological advancement noticed was from clinical T2 (cT2) to pathological T3 (pT3) (43.9%) stage. The majority of the patients (66.1%) received CAB as adjuvant HT, for a median duration of 20.0 months. The least recurrence (15.2%) was noticed in patients treated with CAB, followed by those treated with luteinizing hormone-releasing hormone agonist (LHRHa) (16.1%), and antiandrogen (19.0%), with non-significant difference noted among the groups. None of the baseline or postoperative characteristics was related with PSA recurrence in our study. The 24-month FACT-P QoL score of 119 patients treated for >12 months showed significant improvement above baseline compared with those treated for ≤12 months. Conclusions Adjuvant CAB therapy after RP showed reduction trend in 2-year PSA recurrence rate in high-risk Chinese patients with localized and locally advanced PCa, compared with adjuvant anti-androgens (AA) or LHRHa therapy. Further long-term therapy (>12 months) significantly improved QoL compared to short-term HT therapy, suggesting the beneficial effect of long-term CAB therapy in improving QoL.

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Impact of the duration of hormonal therapy following radiotherapy for localized prostate cancer

Cited by 5 publications

References 25 publications

Is androgen deprivation therapy for prostate cancer associated with cardiovascular disease? A meta‐analysis and systematic review

Is androgen deprivation therapy for prostate cancer associated with cardiovascular disease? A meta‐analysis and systematic review

Androgen deprivation therapy and cardiovascular complications

Adjuvant hormone therapy after radical prostatectomy in high-risk localized and locally advanced prostate cancer: First multicenter, observational study in China

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