Session: MP67: Prostate Cancer: Localized: Surgical Therapy III
MP67-14: VARIATION OF HORMONAL AGENT USAGE WITH POSTOPERATIVE RADIATION THERAPY: RESULTS FROM A POPULATION BASED COHORT OF PROSTATE CANCER PATIENTS IN COMMUNITY ONCOLOGY PRACTICES
Introduction: The optimal hormonal agent for postoperative radiation therapy remains to be defined with either LH-RH agents or androgen receptor blockers. Androgen deprivation therapy appears to be important for some patients receiving postoperative radiation therapy but there are differences in side effects and quality of life. Thus, we used a large national database of community practices to identify practice patterns with hormonal agents in the postoperative radiation therapy settings. Methods: From the CancerLinQ database, which represents more than a 100 community oncology practices in the U.S., we included all men who underwent radical prostatectomy and then received adjuvant or salvage radiation therapy from 2000 to 2021. The primary outcome was concomitant use of hormonal therapy including luteinizing hormone – releasing hormone (LH-RH) agents or androgen receptor blockers. Multivariable logistic regression analyses were used to elucidate patient characteristics associated with use of each class of hormonal agents. Results: Among the 390 surgically treated patients receiving postoperative radiation therapy, 50.7%(n=198) received no hormonal agents, 23.6 % (n=92) received LH-RH agents, and 22.82% (n=89) received both LH-RH agents and androgen receptor blocker. Only 2.8% (n=11) received androgen receptor blocker alone. Among patients with salvage radiation therapy at PSA > 0.7 ng/dl, 51.6% did not receive any form of hormonal therapy. On multivariable analysis, patients with pN1+ compared with pN0 had higher odds of receiving LH-RH agents (OR: 3.21; p = 0.01) during postoperative radiation therapy. Conversely, African American men were less likely to receive androgen receptor blockers compared to white men (OR: 0.24; p = 0.004). Use of hormonal agents were not associated with postoperative radiation therapy intent. Conclusions: Among patients treated in community-based oncology practices in the U.S., most are not receiving any form of hormonal agents with postoperative radiation therapy. Racial disparities also exist in the use of androgen receptor blockers during post-prostatectomy radiation therapy. Increased attention is needed to disseminate evidence into clinical practice. SOURCE OF Funding: Schramm Foundation
