TY  - JOUR
A1  - Wenzel, Mike
A1  - Collà Ruvolo, Claudia
A1  - Würnschimmel, Christoph
A1  - Nocera, Luigi
A1  - Tian, Zhe
A1  - Saad, Fred
A1  - Briganti, Alberto
A1  - Tilki, Derya
A1  - Graefen, Markus
A1  - Becker, Andreas
A1  - Roos, Frederik
A1  - Mandel, Philipp
A1  - Chun, Felix
A1  - Karakiewicz, Pierre I.
T1  - Survival rates with external beam radiation therapy in newly diagnosed elderly metastatic prostate cancer patients
T2  - The prostate
N2  - Background: The survival benefit of primary external beam radiation therapy (EBRT) has never been formally tested in elderly men who were newly diagnosed with metastatic prostate cancer (mPCa). We hypothesized that elderly patients may not benefit of EBRT to the extent as younger newly diagnosed mPCa patients, due to shorter life expectancy.

Methods: We relied on Surveillance, Epidemiology and End Results (2004–2016) to identify elderly newly diagnosed mPCa patients, aged >75 years. Kaplan–Meier, univariable and multivariable Cox regression models, as well as Competing Risks Regression models tested the effect of EBRT versus no EBRT on overall mortality (OM) and cancer-specific mortality (CSM).

Results: Of 6556 patients, 1105 received EBRT (16.9%). M1b stage was predominant in both EBRT (n = 823; 74.5%) and no EBRT (n = 3908; 71.7%, p = 0.06) groups, followed by M1c (n = 211; 19.1% vs. n = 1042; 19.1%, p = 1) and M1a (n = 29; 2.6% vs. n = 268; 4.9%, p < 0.01). Median overall survival (OS) was 23 months for EBRT and 23 months for no EBRT (hazard ratio [HR]: 0.97, p = 0.6). Similarly, median cancer-specific survival (CSS) was 29 months for EBRT versus 30 months for no EBRT (HR: 1.04, p = 0.4). After additional multivariable adjustment, EBRT was not associated with lower OM or lower CSM in the entire cohort, as well as after stratification for M1b and M1c substages.

Conclusions: In elderly men who were newly diagnosed with mPCa, EBRT does not affect OS or CSS. In consequence, our findings question the added value of local EBRT in elderly newly diagnosed mPCa patients.
KW  - cancer-specific survival
KW  - EBRT
KW  - elderly
KW  - local treatment
KW  - overall survival
Y1  - 2021
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/74546
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-745468
SN  - 1097-0045
N1  - DATA AVAILABILITY STATEMENT: All data generated for this analysis were from the SEER 18 database. The code for the analyses will be made available after request.
VL  - 82
IS  - 1
SP  - 78
EP  - 85
PB  - Wiley-Liss
CY  - New York, NY
ER  -