Identification of comorbidities that place men at highest risk of death from androgen deprivation therapy before brachytherapy for prostate cancer
Abstract Purpose To determine which specific comorbidities predispose men to excess mortality by androgen deprivation therapy (ADT) given before and during brachytherapy for prostate cancer. Methods and Materials We analyzed 5972 men with T1c–T3b prostate cancer treated with brachytherapy-based radi...
Gespeichert in:
Veröffentlicht in: | Brachytherapy 2013-09, Vol.12 (5), p.415-421 |
---|---|
Hauptverfasser: | , , , , , , , , , , , , , , , |
Format: | Artikel |
Sprache: | eng |
Schlagworte: | |
Online-Zugang: | Volltext |
Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
container_end_page | 421 |
---|---|
container_issue | 5 |
container_start_page | 415 |
container_title | Brachytherapy |
container_volume | 12 |
creator | Parekh, Arti Chen, Ming-Hui D’Amico, Anthony V Dosoretz, Daniel E Ross, Rudi Salenius, Sharon Graham, Powell L Beckman, Joshua A Beard, Clair J Choueiri, Toni K Ennis, Ronald D Hoffman, Karen E Hu, Jim C Ma, Jing Martin, Neil E Nguyen, Paul L |
description | Abstract Purpose To determine which specific comorbidities predispose men to excess mortality by androgen deprivation therapy (ADT) given before and during brachytherapy for prostate cancer. Methods and Materials We analyzed 5972 men with T1c–T3b prostate cancer treated with brachytherapy-based radiation with or without neoadjuvant ADT. Cox multivariable analysis with propensity scoring was used to determine if ADT was associated with increased all-cause mortality (ACM) in men divided into groups stratified by cardiac comorbidities. Tests for interaction between risk group and outcome were performed. Results ADT was associated with increased ACM in men with a history of myocardial infarction or congestive heart failure, regardless of whether they underwent revascularization (adjusted hazard ratio [AHR], 2.1 [95% confidence interval {CI}, 1.02–4.17; p = 0.04]) or not (AHR, 1.8 [95% CI, 1.05–3.20; p = 0.03]), but this effect was not seen in men with less severe comorbidity. However, among men with diabetes, there was a significant interaction with risk group ( p = 0.01) such that ADT was associated with excess mortality in men with low-risk disease (AHR = 2.21 [1.04–4.68]; p = 0.04) but not in men with intermediate or high-risk disease (AHR, 0.64 [0.33–1.22]; p = 0.17). Conclusions ADT was associated with excess ACM in all patients with a history of congestive heart failure or myocardial infarction, regardless of whether they were revascularized, and in diabetics with low-risk disease. ADT for gland downsizing before brachytherapy should be avoided in these men. |
doi_str_mv | 10.1016/j.brachy.2013.02.005 |
format | Article |
fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1432075641</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S1538472113002419</els_id><sourcerecordid>1432075641</sourcerecordid><originalsourceid>FETCH-LOGICAL-c417t-6e79046c34787f5120edab81a448764dcfd3d30e4b087aac836204e6b3c0eeea3</originalsourceid><addsrcrecordid>eNqFUstu1TAQtRAVfcAfIOQlmwS_YicbJFQVqFSJRdu15diTxrdJfLF9K93f4ItxlLYLNqw8Hp0zM2fOIPSRkpoSKr_s6j4aOx5rRiivCasJad6gM9oqXlEhurclbnhbCcXoKTpPaUcKreP8HTplXDa0Y_IM_bl2sGQ_eGuyDwsOA7ZhDrH3zmcPCefRZLyfjAU8w4LLZ_QPI6SMo0-PK96BySMeYpixWVwMDwXmYB_901YyjxDN_oh7GEIEvE39kiwpvI8hZZMBW7NYiO_RyWCmBB-e3wt0__3q7vJndfPrx_Xlt5vKCqpyJUF1REjLhWrV0FBGwJm-pUaIVknh7OC44wRET1pljG25ZESA7LklAGD4Bfq81S39fx-KIj37ZGGazALhkDQVnBHVSEELVGxQW0ZNEQZd5M0mHjUlenVD7_SmS69uaMJ0caPQPj13OPQzuFfSy_oL4OsGgKLzyUPUyXooS3A-gs3aBf-_Dv8WsJNfipnTIxwh7cIhLmWHmupUCPp2vYj1ICgnhAna8b8FDLVt</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1432075641</pqid></control><display><type>article</type><title>Identification of comorbidities that place men at highest risk of death from androgen deprivation therapy before brachytherapy for prostate cancer</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals Complete</source><creator>Parekh, Arti ; Chen, Ming-Hui ; D’Amico, Anthony V ; Dosoretz, Daniel E ; Ross, Rudi ; Salenius, Sharon ; Graham, Powell L ; Beckman, Joshua A ; Beard, Clair J ; Choueiri, Toni K ; Ennis, Ronald D ; Hoffman, Karen E ; Hu, Jim C ; Ma, Jing ; Martin, Neil E ; Nguyen, Paul L</creator><creatorcontrib>Parekh, Arti ; Chen, Ming-Hui ; D’Amico, Anthony V ; Dosoretz, Daniel E ; Ross, Rudi ; Salenius, Sharon ; Graham, Powell L ; Beckman, Joshua A ; Beard, Clair J ; Choueiri, Toni K ; Ennis, Ronald D ; Hoffman, Karen E ; Hu, Jim C ; Ma, Jing ; Martin, Neil E ; Nguyen, Paul L</creatorcontrib><description>Abstract Purpose To determine which specific comorbidities predispose men to excess mortality by androgen deprivation therapy (ADT) given before and during brachytherapy for prostate cancer. Methods and Materials We analyzed 5972 men with T1c–T3b prostate cancer treated with brachytherapy-based radiation with or without neoadjuvant ADT. Cox multivariable analysis with propensity scoring was used to determine if ADT was associated with increased all-cause mortality (ACM) in men divided into groups stratified by cardiac comorbidities. Tests for interaction between risk group and outcome were performed. Results ADT was associated with increased ACM in men with a history of myocardial infarction or congestive heart failure, regardless of whether they underwent revascularization (adjusted hazard ratio [AHR], 2.1 [95% confidence interval {CI}, 1.02–4.17; p = 0.04]) or not (AHR, 1.8 [95% CI, 1.05–3.20; p = 0.03]), but this effect was not seen in men with less severe comorbidity. However, among men with diabetes, there was a significant interaction with risk group ( p = 0.01) such that ADT was associated with excess mortality in men with low-risk disease (AHR = 2.21 [1.04–4.68]; p = 0.04) but not in men with intermediate or high-risk disease (AHR, 0.64 [0.33–1.22]; p = 0.17). Conclusions ADT was associated with excess ACM in all patients with a history of congestive heart failure or myocardial infarction, regardless of whether they were revascularized, and in diabetics with low-risk disease. ADT for gland downsizing before brachytherapy should be avoided in these men.</description><identifier>ISSN: 1538-4721</identifier><identifier>EISSN: 1873-1449</identifier><identifier>DOI: 10.1016/j.brachy.2013.02.005</identifier><identifier>PMID: 23651926</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Aged ; Androgen Antagonists - administration & dosage ; Androgen deprivation therapy ; Brachytherapy - methods ; Cardiac death ; Cause of Death - trends ; Comorbidity ; Diabetes ; Follow-Up Studies ; Hematology, Oncology and Palliative Medicine ; Humans ; Incidence ; Male ; Myocardial Infarction - epidemiology ; Neoadjuvant Therapy ; Prostate cancer ; Prostatic Neoplasms - epidemiology ; Prostatic Neoplasms - therapy ; Radiology ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Survival Rate - trends ; United States - epidemiology</subject><ispartof>Brachytherapy, 2013-09, Vol.12 (5), p.415-421</ispartof><rights>American Brachytherapy Society</rights><rights>2013 American Brachytherapy Society</rights><rights>Copyright © 2013 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c417t-6e79046c34787f5120edab81a448764dcfd3d30e4b087aac836204e6b3c0eeea3</citedby><cites>FETCH-LOGICAL-c417t-6e79046c34787f5120edab81a448764dcfd3d30e4b087aac836204e6b3c0eeea3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.brachy.2013.02.005$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23651926$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Parekh, Arti</creatorcontrib><creatorcontrib>Chen, Ming-Hui</creatorcontrib><creatorcontrib>D’Amico, Anthony V</creatorcontrib><creatorcontrib>Dosoretz, Daniel E</creatorcontrib><creatorcontrib>Ross, Rudi</creatorcontrib><creatorcontrib>Salenius, Sharon</creatorcontrib><creatorcontrib>Graham, Powell L</creatorcontrib><creatorcontrib>Beckman, Joshua A</creatorcontrib><creatorcontrib>Beard, Clair J</creatorcontrib><creatorcontrib>Choueiri, Toni K</creatorcontrib><creatorcontrib>Ennis, Ronald D</creatorcontrib><creatorcontrib>Hoffman, Karen E</creatorcontrib><creatorcontrib>Hu, Jim C</creatorcontrib><creatorcontrib>Ma, Jing</creatorcontrib><creatorcontrib>Martin, Neil E</creatorcontrib><creatorcontrib>Nguyen, Paul L</creatorcontrib><title>Identification of comorbidities that place men at highest risk of death from androgen deprivation therapy before brachytherapy for prostate cancer</title><title>Brachytherapy</title><addtitle>Brachytherapy</addtitle><description>Abstract Purpose To determine which specific comorbidities predispose men to excess mortality by androgen deprivation therapy (ADT) given before and during brachytherapy for prostate cancer. Methods and Materials We analyzed 5972 men with T1c–T3b prostate cancer treated with brachytherapy-based radiation with or without neoadjuvant ADT. Cox multivariable analysis with propensity scoring was used to determine if ADT was associated with increased all-cause mortality (ACM) in men divided into groups stratified by cardiac comorbidities. Tests for interaction between risk group and outcome were performed. Results ADT was associated with increased ACM in men with a history of myocardial infarction or congestive heart failure, regardless of whether they underwent revascularization (adjusted hazard ratio [AHR], 2.1 [95% confidence interval {CI}, 1.02–4.17; p = 0.04]) or not (AHR, 1.8 [95% CI, 1.05–3.20; p = 0.03]), but this effect was not seen in men with less severe comorbidity. However, among men with diabetes, there was a significant interaction with risk group ( p = 0.01) such that ADT was associated with excess mortality in men with low-risk disease (AHR = 2.21 [1.04–4.68]; p = 0.04) but not in men with intermediate or high-risk disease (AHR, 0.64 [0.33–1.22]; p = 0.17). Conclusions ADT was associated with excess ACM in all patients with a history of congestive heart failure or myocardial infarction, regardless of whether they were revascularized, and in diabetics with low-risk disease. ADT for gland downsizing before brachytherapy should be avoided in these men.</description><subject>Aged</subject><subject>Androgen Antagonists - administration & dosage</subject><subject>Androgen deprivation therapy</subject><subject>Brachytherapy - methods</subject><subject>Cardiac death</subject><subject>Cause of Death - trends</subject><subject>Comorbidity</subject><subject>Diabetes</subject><subject>Follow-Up Studies</subject><subject>Hematology, Oncology and Palliative Medicine</subject><subject>Humans</subject><subject>Incidence</subject><subject>Male</subject><subject>Myocardial Infarction - epidemiology</subject><subject>Neoadjuvant Therapy</subject><subject>Prostate cancer</subject><subject>Prostatic Neoplasms - epidemiology</subject><subject>Prostatic Neoplasms - therapy</subject><subject>Radiology</subject><subject>Retrospective Studies</subject><subject>Risk Assessment</subject><subject>Risk Factors</subject><subject>Survival Rate - trends</subject><subject>United States - epidemiology</subject><issn>1538-4721</issn><issn>1873-1449</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFUstu1TAQtRAVfcAfIOQlmwS_YicbJFQVqFSJRdu15diTxrdJfLF9K93f4ItxlLYLNqw8Hp0zM2fOIPSRkpoSKr_s6j4aOx5rRiivCasJad6gM9oqXlEhurclbnhbCcXoKTpPaUcKreP8HTplXDa0Y_IM_bl2sGQ_eGuyDwsOA7ZhDrH3zmcPCefRZLyfjAU8w4LLZ_QPI6SMo0-PK96BySMeYpixWVwMDwXmYB_901YyjxDN_oh7GEIEvE39kiwpvI8hZZMBW7NYiO_RyWCmBB-e3wt0__3q7vJndfPrx_Xlt5vKCqpyJUF1REjLhWrV0FBGwJm-pUaIVknh7OC44wRET1pljG25ZESA7LklAGD4Bfq81S39fx-KIj37ZGGazALhkDQVnBHVSEELVGxQW0ZNEQZd5M0mHjUlenVD7_SmS69uaMJ0caPQPj13OPQzuFfSy_oL4OsGgKLzyUPUyXooS3A-gs3aBf-_Dv8WsJNfipnTIxwh7cIhLmWHmupUCPp2vYj1ICgnhAna8b8FDLVt</recordid><startdate>20130901</startdate><enddate>20130901</enddate><creator>Parekh, Arti</creator><creator>Chen, Ming-Hui</creator><creator>D’Amico, Anthony V</creator><creator>Dosoretz, Daniel E</creator><creator>Ross, Rudi</creator><creator>Salenius, Sharon</creator><creator>Graham, Powell L</creator><creator>Beckman, Joshua A</creator><creator>Beard, Clair J</creator><creator>Choueiri, Toni K</creator><creator>Ennis, Ronald D</creator><creator>Hoffman, Karen E</creator><creator>Hu, Jim C</creator><creator>Ma, Jing</creator><creator>Martin, Neil E</creator><creator>Nguyen, Paul L</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20130901</creationdate><title>Identification of comorbidities that place men at highest risk of death from androgen deprivation therapy before brachytherapy for prostate cancer</title><author>Parekh, Arti ; Chen, Ming-Hui ; D’Amico, Anthony V ; Dosoretz, Daniel E ; Ross, Rudi ; Salenius, Sharon ; Graham, Powell L ; Beckman, Joshua A ; Beard, Clair J ; Choueiri, Toni K ; Ennis, Ronald D ; Hoffman, Karen E ; Hu, Jim C ; Ma, Jing ; Martin, Neil E ; Nguyen, Paul L</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c417t-6e79046c34787f5120edab81a448764dcfd3d30e4b087aac836204e6b3c0eeea3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Aged</topic><topic>Androgen Antagonists - administration & dosage</topic><topic>Androgen deprivation therapy</topic><topic>Brachytherapy - methods</topic><topic>Cardiac death</topic><topic>Cause of Death - trends</topic><topic>Comorbidity</topic><topic>Diabetes</topic><topic>Follow-Up Studies</topic><topic>Hematology, Oncology and Palliative Medicine</topic><topic>Humans</topic><topic>Incidence</topic><topic>Male</topic><topic>Myocardial Infarction - epidemiology</topic><topic>Neoadjuvant Therapy</topic><topic>Prostate cancer</topic><topic>Prostatic Neoplasms - epidemiology</topic><topic>Prostatic Neoplasms - therapy</topic><topic>Radiology</topic><topic>Retrospective Studies</topic><topic>Risk Assessment</topic><topic>Risk Factors</topic><topic>Survival Rate - trends</topic><topic>United States - epidemiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Parekh, Arti</creatorcontrib><creatorcontrib>Chen, Ming-Hui</creatorcontrib><creatorcontrib>D’Amico, Anthony V</creatorcontrib><creatorcontrib>Dosoretz, Daniel E</creatorcontrib><creatorcontrib>Ross, Rudi</creatorcontrib><creatorcontrib>Salenius, Sharon</creatorcontrib><creatorcontrib>Graham, Powell L</creatorcontrib><creatorcontrib>Beckman, Joshua A</creatorcontrib><creatorcontrib>Beard, Clair J</creatorcontrib><creatorcontrib>Choueiri, Toni K</creatorcontrib><creatorcontrib>Ennis, Ronald D</creatorcontrib><creatorcontrib>Hoffman, Karen E</creatorcontrib><creatorcontrib>Hu, Jim C</creatorcontrib><creatorcontrib>Ma, Jing</creatorcontrib><creatorcontrib>Martin, Neil E</creatorcontrib><creatorcontrib>Nguyen, Paul L</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Brachytherapy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Parekh, Arti</au><au>Chen, Ming-Hui</au><au>D’Amico, Anthony V</au><au>Dosoretz, Daniel E</au><au>Ross, Rudi</au><au>Salenius, Sharon</au><au>Graham, Powell L</au><au>Beckman, Joshua A</au><au>Beard, Clair J</au><au>Choueiri, Toni K</au><au>Ennis, Ronald D</au><au>Hoffman, Karen E</au><au>Hu, Jim C</au><au>Ma, Jing</au><au>Martin, Neil E</au><au>Nguyen, Paul L</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Identification of comorbidities that place men at highest risk of death from androgen deprivation therapy before brachytherapy for prostate cancer</atitle><jtitle>Brachytherapy</jtitle><addtitle>Brachytherapy</addtitle><date>2013-09-01</date><risdate>2013</risdate><volume>12</volume><issue>5</issue><spage>415</spage><epage>421</epage><pages>415-421</pages><issn>1538-4721</issn><eissn>1873-1449</eissn><abstract>Abstract Purpose To determine which specific comorbidities predispose men to excess mortality by androgen deprivation therapy (ADT) given before and during brachytherapy for prostate cancer. Methods and Materials We analyzed 5972 men with T1c–T3b prostate cancer treated with brachytherapy-based radiation with or without neoadjuvant ADT. Cox multivariable analysis with propensity scoring was used to determine if ADT was associated with increased all-cause mortality (ACM) in men divided into groups stratified by cardiac comorbidities. Tests for interaction between risk group and outcome were performed. Results ADT was associated with increased ACM in men with a history of myocardial infarction or congestive heart failure, regardless of whether they underwent revascularization (adjusted hazard ratio [AHR], 2.1 [95% confidence interval {CI}, 1.02–4.17; p = 0.04]) or not (AHR, 1.8 [95% CI, 1.05–3.20; p = 0.03]), but this effect was not seen in men with less severe comorbidity. However, among men with diabetes, there was a significant interaction with risk group ( p = 0.01) such that ADT was associated with excess mortality in men with low-risk disease (AHR = 2.21 [1.04–4.68]; p = 0.04) but not in men with intermediate or high-risk disease (AHR, 0.64 [0.33–1.22]; p = 0.17). Conclusions ADT was associated with excess ACM in all patients with a history of congestive heart failure or myocardial infarction, regardless of whether they were revascularized, and in diabetics with low-risk disease. ADT for gland downsizing before brachytherapy should be avoided in these men.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>23651926</pmid><doi>10.1016/j.brachy.2013.02.005</doi><tpages>7</tpages></addata></record> |
fulltext | fulltext |
identifier | ISSN: 1538-4721 |
ispartof | Brachytherapy, 2013-09, Vol.12 (5), p.415-421 |
issn | 1538-4721 1873-1449 |
language | eng |
recordid | cdi_proquest_miscellaneous_1432075641 |
source | MEDLINE; Elsevier ScienceDirect Journals Complete |
subjects | Aged Androgen Antagonists - administration & dosage Androgen deprivation therapy Brachytherapy - methods Cardiac death Cause of Death - trends Comorbidity Diabetes Follow-Up Studies Hematology, Oncology and Palliative Medicine Humans Incidence Male Myocardial Infarction - epidemiology Neoadjuvant Therapy Prostate cancer Prostatic Neoplasms - epidemiology Prostatic Neoplasms - therapy Radiology Retrospective Studies Risk Assessment Risk Factors Survival Rate - trends United States - epidemiology |
title | Identification of comorbidities that place men at highest risk of death from androgen deprivation therapy before brachytherapy for prostate cancer |
url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-25T12%3A19%3A42IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Identification%20of%20comorbidities%20that%20place%20men%20at%20highest%20risk%20of%20death%20from%20androgen%20deprivation%20therapy%20before%20brachytherapy%20for%20prostate%20cancer&rft.jtitle=Brachytherapy&rft.au=Parekh,%20Arti&rft.date=2013-09-01&rft.volume=12&rft.issue=5&rft.spage=415&rft.epage=421&rft.pages=415-421&rft.issn=1538-4721&rft.eissn=1873-1449&rft_id=info:doi/10.1016/j.brachy.2013.02.005&rft_dat=%3Cproquest_cross%3E1432075641%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1432075641&rft_id=info:pmid/23651926&rft_els_id=S1538472113002419&rfr_iscdi=true |