New German study below [1].
The elderly patients were at least 75 at diagnosis.
Only 2 more years & I will finally be elderly. I wonder what it will be like? LOL. As a group, older guys obviously have shorter life expectancy, but there has to be a better way to define 'elderly' than age. What about comorbidities & shouldn't there be some credit for those who run 10 miles before breakfast, etc?
"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% ...) groups, followed by M1c (n = 211; 19.1% vs. n = 1042; 19.1%, ...) and M1a (n = 29; 2.6% vs. n = 268; 4.9%, ...).
"Median overall survival (OS) was 23 months for EBRT and 23 months for no EBRT (hazard ratio [HR] ...).
"Similarly, median cancer-specific survival (CSS) was 29 months for EBRT versus 30 months for no EBRT (HR: 1.04 ...).
"After additional multivariable adjustment, EBRT was not associated with lower {overall mortality} or lower {cancer-specific mortality} in the entire cohort, as well as after stratification for M1b and M1c substages."
"... our findings question the added value of local EBRT in elderly newly diagnosed mPCa patients."
-Patrick
[1] pubmed.ncbi.nlm.nih.gov/346...
Prostate
. 2021 Oct 11. doi: 10.1002/pros.24249. Online ahead of print.
Survival rates with external beam radiation therapy in newly diagnosed elderly metastatic prostate cancer patients
Mike Wenzel 1 2 , Claudia Collà Ruvolo 2 3 , Christoph Würnschimmel 2 4 , Luigi Nocera 2 5 , Zhe Tian 2 , Fred Saad 2 , Alberto Briganti 3 , Derya Tilki 4 6 , Markus Graefen 4 , Andreas Becker 1 , Frederik Roos 1 , Philipp Mandel 1 , Felix K H Chun 1 , Pierre I Karakiewicz 2
Affiliations collapse
Affiliations
1 Department of Urology, University Hospital Frankfurt, Goethe University Frankfurt am Main, Frankfurt, Germany.
2 Division of Urology, Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada.
3 Department of Neurosciences, Reproductive Sciences, and Odontostomatology, University of Naples Federico II, Naples, Italy.
4 Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany.
5 Department of Urology and Division of Experimental Oncology, Urological Research Institute (URI), IRCCS San Raffaele Scientific Institute, Milan, Italy.
6 Department of Urology, University Hospital Hamburg-Eppendorf, Hamburg, Germany.
PMID: 34633102 DOI: 10.1002/pros.24249
Abstract
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.
Keywords: EBRT; cancer-specific survival; elderly; local treatment; overall survival.
© 2021 The Authors. The Prostate published by Wiley Periodicals LLC.
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Addition of an ARSI to standard ADT significantly increases the risk of fractures and falls in men with prostate cancer
"Early initiation of Lu-177 PSMA radioligand therapy prolongs overall survival in metastatic prostate cancer"
