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Asian J Urol. 2016 Jan;3(1):33-38. doi: 10.1016/j.ajur.2015.10.003. Epub 2015 Oct 31.

Zoledronic acid combined with androgen-deprivation therapy may prolong time to castration-resistant prostate cancer in hormone-naïve metastatic prostate cancer patients - A propensity scoring approach.

Author information

1
Department of Urology, Graduate School of Medicine, Yamaguchi University, Japan.
2
Department of Urology, Kinki University Faculty of Medicine, Japan.
3
Department of Urology, Wakayama Medical University School of Medicine, Japan.
4
Department of Urology, Sakai Hospital, Kinki University Faculty of Medicine, Japan.
5
Department of Urology, Naga Hospital, Japan.
6
Department of Urology, NTT Osaka Hospital, Japan.
7
Department of Urology, National Hospital Organization Osaka Minami Medical Center, Japan.
8
Department of Urology, Nara Hospital Kinki University Faculty of Medicine, Japan.
9
Department of Urology, Tondabayashi Hospital, Japan.
10
Department of Urology, Wakayama Rosai Hospital, Japan.
11
Department of Urology, Kainan Municipal Hospital, Japan.
12
Department of Urology, Izumiotsu Municipal Hospital, Japan.

Abstract

Objective:

To clarify the oncological benefit of zoledronic acid for hormone-naïve metastatic prostate cancer, patient outcome of androgen deprivation therapy with zoledronic acid (ADT + Z) and androgen deprivation therapy alone (ADT) was compared.

Methods:

Fifty-two patients with pathologically confirmed metastatic prostate cancer were prospectively enrolled and treated with combined androgen blockade (goserelin and bicalutamide) with zoledronic acid (4 mg every 4 weeks for 24 months). A propensity score-match with logistic regression analysis was applied to select 50 pair-matched cohorts (both from ADT + Z and from historical control cohorts who had undergone ADT alone), and patient outcomes were compared.

Results:

Patients with ADT + Z had significantly longer time to progression (TTP) than those with ADT (median TTP; 24.2 vs. 14.0 months, p = 0.0092), while no significant difference of overall survival between two groups (p = 0.1502). Multivariate analysis for biochemical recurrence revealed treatment with ADT was the sole independent prognostic factor (HR: 1.724, 95% CI: 1.06-2.86, p = 0.0297).

Conclusion:

Combination of zoledronic acid with ADT may prolong time to castration resistant prostate cancer.

KEYWORDS:

Biochemical recurrence; Hormone-naïve prostate cancer; Propensity score-match analysis; Zoledronic acid

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