Prostate Cancer and COVID-19: Does Timing of Treatment Affect Survival Outcomes?
Posted: Tuesday, August 25, 2020
The challenge of treating patients with prostate cancer who also have COVID-19 is whether treatment consisting of radiotherapy and/or androgen-deprivation therapy (ADT) should be delayed until the infection has been eradicated. A team of researchers, led by Vinayak Muralidhar, MD, MSc, of Dana-Farber Cancer Institute, Boston, analyzed data from a large, contemporary database of patients with clinically significant localized prostate cancer to examine the association between overall survival and the timing of administration of radiotherapy. Their study data, which were published in JAMA Oncology, indicate that later radiotherapy up to 6 months after initiation of ADT was not associated with worse overall survival than starting radiotherapy before ADT.
The study focused on data from 63,858 men, nearly 80% of whom were White. Among men with unfavorable intermediate-risk prostate cancer (4,220 total deaths), the 10-year overall survival rate for men who initiated radiotherapy 0 to 60 days before ADT was 59.2%, and among patients who received radiotherapy 1 to 60 days after start of ADT was 57.9%. In addition, the 10-year overall survival in those who initiated radiotherapy 61 to 120 days after the start of ADT was 62.3%, compared with 58.9% with radiotherapy started 121 to 180 days after ADT. No difference in overall survival was found for groups receiving later radiotherapy compared with those receiving radiotherapy 0 to 60 days before initiation of ADT.
Of further note, among men with high-risk or very high–risk prostate cancer (10,959 total deaths), the 10-year rate of overall survival for men who initiated radiotherapy 0 to 60 days before the start of ADT was 58.9%, compared with 51.7% for radiotherapy given 1 to 60 days after the start of ADT, 54.8% for radiotherapy given 61 to 120 days after the start of ADT, and 52.4% for radiotherapy given 121 to 180 days after the start of ADT.
Disclosure: For full disclosures of the study authors, visit jamanetwork.com.
