Are physicians consistent in their recommendation for intermittent versus continuous ADT across the USA?

Adoption of Intermittent Androgen Deprivation Therapy for Advanced Prostate Cancer: A Population Based Study in American Urology Practice. By Tsai et al. 2015 

 

Key sentence from the paper: “…substantial geographic variation exists in [intermittent ADT] adoption, underscoring uncertainty and disagreement about the relative value of [intermittent ADT] vs the more established [continuous ADT].”

 

For the full abstract, see: http://www.urologypracticejournal.com/article/S2352-0779(14)00207-6/abstract

 

Commentary: One of the biggest questions in the use of ADT concerns whether intermittent administration is as effective as continuous administration. In fact there are even hypothetical arguments for why intermittent administration may be better than continuous ADT, particularly in terms of preserving quality of life.

In this paper the authors, like many of the authors of other papers reviewed in this blog, use the SEER-Medicare data set. They included data on 4,281 men from across the United States, who were treated with ADT. What the authors found, which was not surprising, was that intermittent ADT was administered less in patients with metastatic disease compared to those prescribed ADT just because of a rising PSA. Their major conclusion was simply that there is no consistency across the United States in how or when physicians prescribe intermittent versus continuous ADT.

  

Tsai HT, Penson D, Luta G, Lynch JH, Zhou Y, Potosky AL. 2015. Adoption of Intermittent Androgen Deprivation Therapy for Advanced Prostate Cancer: A Population Based Study in American Urology Practice. Urology Practice. 15 April 2015 [Epub ahead of print]