Radiotherapy for Men With Prostate Cancer: Consider History of Medication Allergies
Posted: Tuesday, January 5, 2021
Men with medication allergies treated with radiotherapy for prostate cancer seem to have better rates of freedom from biochemical failure but higher rates of treatment-related toxicity than those with no medication allergies, according to a study of patients with nonmetastatic prostate cancer. Stanley L. Liauw, MD, of the University of Chicago, and colleagues published their results in JNCI Cancer Spectrum.
“If these results are validated, men with medication allergies who receive radiotherapy may be more strongly considered for treatment modifications such as the placement of a hydrogel rectal spacer and adoption of more stringent rectal-sparing constraints, both of which have been demonstrated to reduce rates of long-term genitourinary and gastrointestinal morbidity,” the authors wrote.
The study included 587 men who received radiotherapy for nonmetastatic prostate cancer between 1989 and 2006. Of these patients, 26.4% (n = 155) had known medication allergies, and the rest had no history of medication allergies. The most common allergies were penicillin (71 patients), sulfa (35 patients), and aspirin/nonsteroidal anti-inflammatory drugs (28 patients).
Patients with medication allergies had significantly better 10-year rates of freedom from biochemical failure (71.5%) than those without such allergies (63.5%), with a hazard ratio of 0.64. However, men with medication allergies also had increased treatment-related toxicity: a higher incidence of late-stage grade 3 or higher genitourinary adverse effects (hazard ratio = 2.69) and a higher incidence of late-stage grade 2 or higher gastrointestinal adverse effects (hazard ratio = 1.76), even after the investigators controlled for covariates.
Limitations of the study include its single-institution, retrospective nature. Future studies could attempt to validate these results or study whether interventions such as hydrogel rectal spacers would ameliorate toxicity in this patient population.
Disclosure: The study authors reported no conflicts of interest.
