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    Nonrandomized comparison of efficacy and side effects of bicalutamide compared with luteinizing hormone-releasing hormone (LHRH) analogs in combination with radiation therapy in the CHHiP trial

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    Authors
    Tree, A.
    Griffin, C.
    Syndikus, I.
    Birtle, A.
    Choudhury, Ananya
    Graham, J.
    Ferguson, C.
    Khoo, V.
    Malik, Z.
    O'Sullivan, J.
    Panades, M.
    Parker, C.
    Rimmer, Y.
    Scrase, C.
    Staffurth, J.
    Dearnaley, D.
    Hall, E.
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    Affiliation
    Royal Marsden NHS Foundation Trust, London, United Kingdom; Institute of Cancer Research, London, United Kingdom
    Issue Date
    2022
    
    Metadata
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    Abstract
    Purpose: CHHiP is a randomized trial evaluating moderately hypofractionated radiation therapy for treatment of localized prostate cancer. Of all participants, 97% of them had concurrent short-course hormone therapy (HT), either luteinizing hormone-releasing hormone analog (LHRHa) or 150 mg of bicalutamide daily. This exploratory analysis compares efficacy and side effects in a nonrandomized comparison. Methods and materials: In our study, 2700 patients received LHRHa and 403 received bicalutamide. The primary endpoint was biochemical/clinical failure. Groups were compared with Cox regression adjusted for various prognostic factors and stratified by radiation therapy dose. A key secondary endpoint was erectile dysfunction (ED) assessed by clinicians (using scores from Late Effects on Normal Tissues: Subjective/Objective/Management [LENT-SOM] subjective erectile function for vaginal penetration) and patients (single items within the University of California-Los Angeles Prostate Cancer Index [UCLA PCI] and Expanded Prostate Cancer Index Composite [EPIC]-50 questionnaires) at 2 years and compared between HT regimens by χ2 trend test. Results: Bicalutamide patients were significantly younger (median 67 vs 69 years LHRHa). Median follow-up was 9.3 years. There was no difference in biochemical or clinical failure with an adjusted hazard ratio or 0.97 (95% confidence interval, 0.77-1.23; P = .8). At 2 years, grade ≥2 LENT-SOM ED was reported in significantly more LHRHa patients (313 out of 590; 53%) versus bicalutamide (17 out of 68; 25%) (P < .0001). There were no differences in ED seen with UCLA-PCI and EPIC-50 questionnaires. Conclusions: In this nonrandomized comparison, there was no evidence of a difference in efficacy according to type of HT received. Bicalutamide preserved clinician assessed (LENT-SOM) erectile function at 2 years but patient-reported outcomes were similar between groups.
    Citation
    Tree A, Griffin C, Syndikus I, Birtle A, Choudhury A, Graham J, et al. Nonrandomized Comparison of Efficacy and Side Effects of Bicalutamide Compared With Luteinizing Hormone-Releasing Hormone (LHRH) Analogs in Combination With Radiation Therapy in the CHHiP Trial. International journal of radiation oncology, biology, physics. 2022 Jun 1;113(2):305-15. PubMed PMID: 35017008. Pubmed Central PMCID: 9119688.
    Journal
    International Journal of Radiation Oncology Biology Physics
    URI
    http://hdl.handle.net/10541/625401
    DOI
    10.1016/j.ijrobp.2021.12.160
    PubMed ID
    35017008
    Additional Links
    https://dx.doi.org/10.1016/j.ijrobp.2021.12.160
    Type
    Article
    Language
    en
    ae974a485f413a2113503eed53cd6c53
    10.1016/j.ijrobp.2021.12.160
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