Sex or survival: Short-term versus long-term androgen deprivation in patients with locally advanced prostate cancer treated with radiotherapy

Derek R. Wilke, Murray Krahn, George Tomlinson, Andrea Bezjak, Robert Rutledge, Padraig Warde

Research output: Contribution to journalArticlepeer-review

18 Citations (Scopus)

Abstract

BACKGROUND: Combined long-term androgen deprivation (LTAD) and radiation conveys a prostate cancer-specific survival advantage over combined short-term androgen deprivation (STAD) and radiation. The seminal question is whether or not the gains are worth the adverse effects of LTAD with respect to patient preferences. METHODS: Preferences for LTAD compared with STAD were elicited by direct patient interview using the probability trade-off method. "Time trade-off utilities" (TTOu) for erectile dysfunction and osteoporosis were elicited using the time trade-off method. Participants' current prostate cancer-specific health state was assessed using the Patient-Oriented Prostate Utility Scale-Psychometric. Participants' current sexual function was assessed using the International Index of Erectile Function (IIEF). RESULTS: All participants were willing to trade survival rather than undergo LTAD compared with STAD. The mean minimally required increment in prostate cancer-specific survival (MRIS) was 8.2%. The mean TTOu for impotence was 0.78, and the mean TTOu for osteoporosis was 0.71. The MRIS was correlated with the Sexual Desire domain score of the IIEF (Spearman rank-correlation coefficient, r = 0.50; P<.0001). CONCLUSIONS: Patients desired more prostate cancer-specific survival than what was afforded by LTAD and radiotherapy compared with STAD and radiotherapy.

Original languageEnglish
Pages (from-to)1909-1917
Number of pages9
JournalCancer
Volume116
Issue number8
DOIs
Publication statusPublished - Apr 15 2010

ASJC Scopus Subject Areas

  • Oncology
  • Cancer Research

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