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Updated: Jul 4, 2026
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A Bioluminescent and Fluorescent Orthotopic Syngeneic Murine Model of Androgen-dependent and Castration-resistant Prostate Cancer
Published on: March 6, 2018
Salvage Androgen Deprivation Therapy Use After Definitive Radiotherapy With vs Without Androgen Deprivation Therapy
Jiaye Shen1, Aaron J Katz2, Yahui Xie1
1Department of Radiation Oncology, University of Kansas Medical Center, Kansas City, Kansas, USA.
The Prostate
|July 2, 2026
Summary
Omitting initial androgen deprivation therapy (ADT) during radiotherapy for prostate cancer increases the risk of needing salvage ADT later. Real-world data supports using ADT with radiotherapy to reduce this risk and improve outcomes.
Area of Science:
- Oncology
- Radiotherapy
- Urology
Background:
- Androgen deprivation therapy (ADT) improves outcomes for prostate cancer patients undergoing radiotherapy but is underutilized due to toxicity concerns.
- Patients forgoing initial ADT may require salvage ADT later, highlighting the need for accurate risk assessment.
Purpose of the Study:
- To estimate the real-world risk of salvage ADT after definitive radiotherapy for unfavorable intermediate-risk and high-risk prostate cancer.
- To evaluate the association between concurrent ADT with radiotherapy and the need for subsequent salvage ADT.
Main Methods:
- Retrospective cohort study using SEER-Medicare data (2010-2021) of men aged 66+ treated with external beam radiotherapy.
- Compared outcomes for patients receiving concurrent ADT with radiotherapy versus radiotherapy alone.
- Estimated cumulative incidence of salvage ADT using Fine-Gray models, accounting for death as a competing risk.
Main Results:
- Concurrent ADT with radiotherapy was used in 61.17% of unfavorable intermediate-risk and 89.60% of high-risk patients.
- At 5 years, salvage ADT incidence was 6.07% (RT alone) vs. 3.53% (RT with ADT) for unfavorable intermediate-risk, and 19.17% vs. 5.92% for high-risk.
- Concurrent ADT significantly lowered the risk of salvage ADT in both risk groups (SHR 0.56 and 0.26, respectively).
Conclusions:
- Omission of initial ADT during radiotherapy is linked to a higher risk of requiring salvage ADT for unfavorable intermediate-risk and high-risk prostate cancer.
- Population-based estimates of salvage ADT risk can inform patient counseling and personalized treatment decisions.
