Influence of Hormone Therapy and Testosterone Level on All Cause Survival after Brachytherapy for Localized Prostate Cancer

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INTRODUCTION

To determine the influence of neoadjuvant hormone therapy (NHT) and testosterone level (T) on all cause survival (ACS) following prostate seed implantation (PSI).

METHODS

1776 men with a median age of 66 years (range 31-84) were followed a minimum of 6 years (mean 10.3, range 6-22.4) and had PSI alone or with neoadjuvant hormone therapy (NHT) and or external beam irradiation boost (EBRT). NHT was given to 948 (53.4%) for a median of 6 months (75%ile 3-9). T level was available in 1140 (64.2%) a median of 6.3 years (75%ile 3.2-9.2) following treatment. The presence of co-existing medical conditions including diabetes (AODM), coronary artery disease, alcohol use, asthma, atrial fib, other cancers, heart disease, hypertension, stroke and emphysema was determined pre-treatment. Associations were compared by two-way tables (Pearson chi-square). Survival was computed by Kaplan-Meier method with comparisons by log rank. Hazard rates (HR) were determined by Cox regression analysis.

RESULTS

ACS at 10 and 17 years were 88.5% and 52.9%. 10 and 17-year survival (table) was decreased with the use of NHT (p=0.004), for NHT >6 months (p 65 vs. ≤ 65 years (p 6 months (p

CONCLUSION

A low testosterone level has a significant impact on ACS in men treated with PSI. NHT given for more than 6 months is associated with lower long-term T levels and a T

Funding: none