| Hormone therapy adjuvant to external beam radiotherapy for locally advanced prostate carcinoma: a complication-adjusted number-needed-to-treat analysis. | |
| | |
MedLine Citation:
|
PMID: 14635069 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
BACKGROUND: Hormone therapy commonly is used to treat metastatic, locally advanced, and localized prostate carcinoma. The objective of the current investigation was to determine, using the number-needed-to-treat (NNT) method, the effect of using hormone therapy to treat locally advanced disease, with consideration given to both the complications and the known advantages associated with hormone therapy. METHODS: A literature review was performed to determine 1) the absolute benefit, based on available clinical endpoints, associated with the addition of hormone therapy to external beam radiotherapy for locally advanced prostate carcinoma; 2) the incidence of side effects of short-term and long-term hormone therapy; and 3) the stepwise progression from biochemical failure to death. A model was constructed to estimate the complication/utility-adjusted survival detriment resulting from the side effects of short-term (</= 6 months) and long-term (> 6 months) hormone therapy, and the absolute/unadjusted and complication-adjusted NNTs for the addition of short-term and long-term hormone therapy were computed. In all cases, the magnitudes and signs of the NNTs obtained were used to gauge the effect of hormone therapy. RESULTS: The unadjusted NNTs were positive and in most cases had relatively small magnitudes (the greater the NNT, the smaller the benefit) for both short-term and long-term hormone therapy; these results were expected, and they suggested that there is a strong benefit associated with the use of hormones adjuvant to radiotherapy for locally advanced disease. Adjusted NNTs remained positive and had relatively small magnitudes even after the introduction into the analysis of complications of short-term and long-term hormone therapy. This finding, although weak with respect to the effect of short-term hormone therapy on cause-specific survival, remained robust over the range of values for utility impairment expected from short-term and long-term hormone therapy. CONCLUSIONS: The benefits of short-term and long-term hormone therapy for locally advanced prostate carcinoma appear to be significant and to outweigh the associated side effects. Long-term therapy appears to be better than short-term therapy in terms of virtually all endpoints studied, even when the increased incidence of side effects is considered. The current investigation was successful in the use of the complication-adjusted NNT method for oncologic and radiotherapeutic scenarios in which the results of randomized trials could be summarized, adjusted for treatment toxicity, and individualized to a given patient. |
| | |
Authors:
|
Ashesh B Jani; Johnny Kao; Samuel Hellman |
Related Documents
:
|
9457309 - Intermittent androgen deprivation for clinically localized prostate cancer: initial exp... 18231739 - Sonablate-500 transrectal high-intensity focused ultrasound (hifu) for benign prostatic... 7533689 - Benign prostatic hyperplasia: diagnosis and treatment options. 1988719 - Vacuum tumescence devices: the role of papaverine in the selection of patients. 9800889 - Transurethral radiofrequency hot balloon thermal therapy in chronic nonbacterial prosta... 18279929 - Serum testosterone recovery after cessation of long-term luteinizing hormone-releasing ... 18432159 - Optimizing outcomes in patients with hepatitis c virus genotype 2 or 3. 15683259 - Preliminary results after application of absorbable metal stents in patients with criti... 20847679 - Ocular demodicosis as a potential cause of pediatric blepharoconjunctivitis. |
Publication Detail:
|
Type: Journal Article |
Journal Detail:
|
Title: Cancer Volume: 98 ISSN: 0008-543X ISO Abbreviation: Cancer Publication Date: 2003 Dec |
Date Detail:
|
Created Date: 2003-11-24 Completed Date: 2003-12-09 Revised Date: 2007-11-15 |
Medline Journal Info:
|
Nlm Unique ID: 0374236 Medline TA: Cancer Country: United States |
Other Details:
|
Languages: eng Pagination: 2351-61 Citation Subset: AIM; IM |
Copyright Information:
|
Copyright 2003 American Cancer Society. |
Affiliation:
|
Department of Radiation and Cellular Oncology, University of Chicago, Chicago, Illinois 60637, USA. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Antineoplastic Agents, Hormonal
/
administration & dosage,
adverse effects*,
therapeutic use* Carcinoma / drug therapy*, pathology, radiotherapy* Chemotherapy, Adjuvant / adverse effects Combined Modality Therapy Drug Administration Schedule Humans Male Models, Theoretical* Prognosis Prostatic Neoplasms / drug therapy*, pathology, radiotherapy* Radiotherapy, Adjuvant / adverse effects Randomized Controlled Trials as Topic Survival Analysis |
| Chemical | |
Reg. No./Substance:
|
0/Antineoplastic Agents, Hormonal |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: The percentage of prostate needle biopsy cores with carcinoma from the more involved side of the bio...
Next Document: Clinical features of patients who present with metastatic prostate carcinoma and serum prostate-spec...