PMID- 32400122
OWN - NLM
STAT- MEDLINE
DCOM- 20210503
LR  - 20240329
IS  - 2045-7634 (Electronic)
IS  - 2045-7634 (Linking)
VI  - 9
IP  - 13
DP  - 2020 Jul
TI  - Improved outcomes after radiotherapy for prostate cancer: Anticoagulation, 
      antiplatelet therapy, and platelet count as key factors in disease progression.
PG  - 4667-4675
LID - 10.1002/cam4.3087 [doi]
AB  - BACKGROUND: Several studies have suggested that antiplatelet (AP) or 
      anticoagulant (AC) therapy may improve outcome in men with prostate cancer. We 
      evaluated the effects of AP/AC therapy and tested the hypothesis that platelet 
      count may also be associated with outcomes. METHODS: A total of 482 patients 
      received primary radiotherapy (median dose 72 Gy) for nonmetastatic prostate 
      cancer; 49% received androgen deprivation therapy. NCCN risk was 
      low/intermediate/high risk in 39%/39%/22%. AP/AC therapy and platelet counts were 
      analyzed with respect to freedom from biochemical failure (FFBF, nadir+2), 
      distant metastasis (FFDM), and cause specific survival (CSS). RESULTS: After a 
      median follow-up of 103 months, 10-year FFBF, FFDM, and CSS were 77%, 92%, and 
      96%, respectively. The 10-year cumulative incidence of BF and DM (with death as a 
      competing event) was 19% and 7.0%, respectively. The 32% of men on AP/AC therapy 
      had a lower incidence of 10-year BF (P = .016) and a trend toward a lower 
      incidence of DM (P = .084) and CSS (P = .091). In the entire cohort, lowest 
      platelet quartile (platelet count <187) was associated with higher 10-year BF 
      (31% vs 16%, P = .0042) but not DM (9.4% vs 5.2%, P = .22) nor CSS (P = .76) 
      compared with those patients with platelet count >/=187. AP/AC therapy was 
      associated with a larger absolute reduction in BF for men with lowest platelet 
      quartile (10-year BF of 21% vs 38%, P = .092) vs platelet >/=187 (10-year BF of 10% 
      vs 18%, P = .053). Lowest platelet quartile remained associated with higher BF 
      and DM on multivariable analysis controlling for risk category, WBC, and Hg. 
      CONCLUSION: AP/AC was associated with improved FFBF. Low platelet count was 
      associated with inferior FFBF and FFDM after prostate radiotherapy. This 
      association was tempered when antiplatelet and anticoagulant therapy was 
      administered.
CI  - (c) 2020 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.
FAU - Gutiontov, Stanley I
AU  - Gutiontov SI
AUID- ORCID: 0000-0003-0300-1618
AD  - Department of Radiation and Cellular Oncology, University of Chicago, Chicago, 
      IL, USA.
FAU - Choe, Kevin S
AU  - Choe KS
AD  - Radiation Oncology Associates, Inova Hospital, Fairfax, VA, USA.
FAU - Miller, Jonathan L
AU  - Miller JL
AD  - Department of Pathology, University of Chicago, Chicago, IL, USA.
FAU - Liauw, Stanley L
AU  - Liauw SL
AUID- ORCID: 0000-0002-4701-2469
AD  - Department of Radiation and Cellular Oncology, University of Chicago, Chicago, 
      IL, USA.
LA  - eng
PT  - Journal Article
DEP - 20200513
PL  - United States
TA  - Cancer Med
JT  - Cancer medicine
JID - 101595310
RN  - 0 (Androgen Antagonists)
RN  - 0 (Anticoagulants)
RN  - 0 (Platelet Aggregation Inhibitors)
RN  - EC 3.4.21.77 (Prostate-Specific Antigen)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Androgen Antagonists/therapeutic use
MH  - Anticoagulants/*therapeutic use
MH  - Disease Progression
MH  - Follow-Up Studies
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Platelet Aggregation Inhibitors/*therapeutic use
MH  - Platelet Count
MH  - Prostate-Specific Antigen/blood
MH  - Prostatic Neoplasms/blood/drug therapy/mortality/*radiotherapy
MH  - Radiotherapy Dosage
MH  - Risk
MH  - Time Factors
MH  - Treatment Outcome
PMC - PMC7333841
OTO - NOTNLM
OT  - blood platelets
OT  - prostatic neoplasms
OT  - radiotherapy
COIS- None of the authors declares a conflict of interest.
EDAT- 2020/05/14 06:00
MHDA- 2021/05/04 06:00
PMCR- 2020/05/13
CRDT- 2020/05/14 06:00
PHST- 2019/11/25 00:00 [received]
PHST- 2020/04/07 00:00 [revised]
PHST- 2020/04/08 00:00 [accepted]
PHST- 2020/05/14 06:00 [pubmed]
PHST- 2021/05/04 06:00 [medline]
PHST- 2020/05/14 06:00 [entrez]
PHST- 2020/05/13 00:00 [pmc-release]
AID - CAM43087 [pii]
AID - 10.1002/cam4.3087 [doi]
PST - ppublish
SO  - Cancer Med. 2020 Jul;9(13):4667-4675. doi: 10.1002/cam4.3087. Epub 2020 May 13.