Brachytherapy for Intermediate Risk Prostate Cancer, Androgen Deprivation and the Risk of Death

Androgen Deprivation Therapy added to radiation for high risk prostate cancer increases survival according to randomized studies. However population studies have shown that it may decrease survival in those with a low risk of prostate cancer death. We investigated its use in 3155 men treated with brachytherapy of whom 47% received ADT. The men with intermediate risk prostate cancer, who were older and had more cardiac comorbidity, had an increased risk of cardiac death and decreased overall survival. This was not observed in those with lower risk cancer, who were younger and healthier. ADT should only be used where randomized data has shown survival advantages.

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