Relative Timing of Radiotherapy and Androgen Deprivation for Prostate Cancer and Implications for Treatment During the COVID-19 Pandemic
Ce dossier présente un ensemble d'articles concernant la prise en charge des cancers durant la crise sanitaire liée au COVID-19
The coronavirus disease 2019 (COVID-19) pandemic poses challenges for patients with localized prostate cancer (PC) who require radiotherapy (RT), often administered with 6 to 36 months of androgen deprivation therapy (ADT). Daily hospital trips for RT create many possible points of COVID-19 transmission, and patients with cancer are at high risk of COVID-19 mortality.1 Therefore, an important option for patients being treated with RT and ADT is delayed RT initiation. Two prior randomized trials examined the relative timing of ADT and RT.2,3 Malone et al2 and the NRG Oncology/Radiation Therapy Oncology Group 9413 trial (NRG/RTOG 9413)3 showed no difference in overall survival (OS) when RT was started after ADT initiation vs when RT was started before or concurrently with ADT. However, neither trial had a noninferiority design, they were not powered for OS, and the enrolled patients may have been younger and healthier than the average real-world patient, limiting generalizability. Therefore, we used data from a large, contemporary database of patients with clinically significant localized PC to examine the association between OS and RT timing in patients receiving RT and ADT.
JAMA Oncology , article en libre accès, 2019