Increasing use of gonadotropin‐releasing hormone agonists for the treatment of localized prostate carcinoma

Abstract

BACKGROUND The role of androgen deprivation therapy in prostate carcinoma is controversial in earlier stages of disease. The authors examined the time trends and patterns of use for androgen deprivation in the form of gonadotropin‐releasing hormone (GnRH) agonists or orchiectomy, in population‐based tumor registries. METHODS Data were obtained from the linked Surveillance, Epidemiology and End Results‐Medicare database. A total of 100,274 men with prostate carcinoma diagnosed from 1991 through 1999 were selected. The main outcome was the proportion of men who received ≥ 1 dose of a GnRH agonist in the first 6 months of diagnosis. This was plotted by year and stratified for age, grade, stage as well as primary versus adjuvant usage. Multiple logistic regression was used to examine predictors of GnRH agonist use in the subset of patients with localized cancer. RESULTS There was a consistent increase in GnRH agonist use by year for all ages, stages, and grades. Even in men ≥ 80 years with localized stage and low to moderate grade tumors, primary GnRH agonist use increased over the study period, from 3.7% in 1991 to 30.9% in 1999 (P < 0.001). The multivariable analysis showed that significant variability in GnRH agonist use existed among SEER geographic regions. CONCLUSIONS The use of GnRH agonists for prostate carcinoma increased dramatically during the 1990s. This increase occurred across all stages and histologic grades of prostate carcinoma, and was greatest in patients ≥ 80 years. Cancer 2005. © 2005 American Cancer Society.

Contemporary Trends in Low Risk Prostate Cancer: Risk Assessment and Treatment

“…Use of both primary ADT and NADT has decreased from peaks, respectively, of 10.6% and 15.2% in 2000-2001 to 6.6% and 11.6%, also marking a reversal of trends previously documented in both CaPSURE and SEER. 9,18 This study has limitations. Data are submitted only by patients and urologists; therefore, any treatments by other practitioners that are not reported by patients either to their urologists or in their questionnaires may be missed.…”

Body Composition, Physical Fitness, Functional Performance, Quality of Life, and Fatigue Benefits of Exercise for Prostate Cancer Patients: A Systematic Review

“…. Androgen deprivation therapy is one of the most common treatments for prostate cancer, with data suggesting that ~50% of men with prostate cancer will use ADT at some point in their treatment 20,21 . While ADT slows down the progression of the cancer by its direct action of reducing the production of testosterone, this leads to a variety of side-effects and symptoms that ultimately reduce their quality of life.…”

Effectiveness of androgen deprivation therapy in prolonging survival of older men treated for locoregional prostate cancer

“…However, it is unknown whether efficacy under controlled conditions has been translated into the real-world effectiveness in routine practice. [24][25][26][27] Given the increased use of HT in localized and metastatic CaP over the past many years, 28 and the increased cost, 29 it is imperative to assess the effectiveness of this therapy in prolonging survival for men treated for locoregional CaP in the routine community settings. To determine the effectiveness of ADT in a large community-based cohort of men diagnosed with locoregional CaP, we utilized a large community-based sample from Surveillance Epidemiology and End Results (SEER)-Medicare linked dataset of the National Cancer Institute (NCI).…”