Hormone use after radiotherapy failure: a survey of Canadian uro-oncology specialists
DOI:
https://doi.org/10.5489/cuaj.1175Abstract
Introduction: A survey of Canadian uro-oncology specialists was
performed to assess practice patterns of patients with recurrent
prostate cancer postradiotherapy and to assess the feasibility of
conducting a trial in this setting.
Methods: There were 14 survey questions and 1 demographic question.
Responses were reported by frequency.
Results: There were 96 respondents. Most respondents use both
prostate-specific antigen doubling time (PSAdt) and PSA level
when deciding to start androgen deprivation therapy (ADT) in
asymptomatic patients. About half of respondents start ADT when
PSA is greater than 10 ng/mL or when the PSAdt is less than
6 months. Eighty-six percent felt that the timing of ADT was an
important research question. Over 1500 patients per year were
estimated as being available for such a trial.
Conclusion: After radiotherapy failure, respondents initiated ADT
about half of the time when PSA is less than 10 ng/mL and/or
PSAdt is less than 6 months. A clinical trial examining the timing
of ADT has strong support and appears to be feasible.
Introduction : Un sondage mené auprès d’uro-oncologues cana diens
a été mené afin d’évaluer les tendances concernant le traitement de
patients atteints de cancer récurrent de la prostate après une radiothérapie
et d’évaluer la faisabilité d’une étude dans ce contexte.
Méthodologie : Le sondage comportait 14 questions portant sur les
traitements et 1 question de type démographique. Les réponses
étaient groupées par fréquence.
Résultats : Quatre-vingt-seize médecins ont participé au sondage.
La majorité des répondants se basent sur le temps de doublement
de l’APS et les taux d’APS pour décider du moment optimal pour
amorcer un traitement antiandrogène chez les patients asymptomatiques.
Environ la moitié des répondants entreprennent un traitement
antiandrogène lorsque le taux d’APS dépasse 10 ng/mL ou
lorsque le temps de doublement de l’APS est inférieur à 6 mois.
Quatre-vingt-six pour cent des répondants ont indiqué que le moment
optimal pour l’amorce du traitement antiandrogène représentait
une importante question de recherche. On estime que plus de
1500 patients par année seraient admissibles à une telle étude.
Conclusion : Après l’échec d’une radiothérapie, les répondants entreprennent
un traitement antiandrogène dans environ la moitié des
cas lorsque l’APS est inférieur à 10 ng/mL et/ou lorsque le temps
de doublement de l’APS est inférieur à 6 mois. Un essai clinique
portant sur la détermination du moment optimal pour l’amorce du
traitement antiandrogène est fortement souhaité et semble faisable.
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