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. 2009 Dec;3(6):460-4.
doi: 10.5489/cuaj.1175.

Hormone use after radiotherapy failure: a survey of Canadian uro-oncology specialists

D Andrew Loblaw  1 , Tom Pickles, Patrick C Cheung, Himu Lukka, Sergio Faria, Laurence Klotz
Affiliations

Hormone use after radiotherapy failure: a survey of Canadian uro-oncology specialists

D Andrew Loblaw et al. Can Urol Assoc J. 2009 Dec.

Abstract
in English, French

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 canadiens 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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