title: Obesity and the Odds of Weight Gain following Androgen Deprivation Therapy for Prostate Cancer.
abstract: Background. Increasing body mass index (BMI) is associated with increased risk of mortality; however, quantifying weight gain in men undergoing androgen deprivation therapy (ADT) for prostate cancer (PC) remains unexplored. Methods. Between 1995 and 2001, 206 men were enrolled in a randomized trial evaluating the survival difference of adding 6 months of ADT to radiation therapy (RT). BMI measurements were available in 171 men comprising the study cohort. The primary endpoint was weight gain of ≥10 lbs by 6-month followup. Logistic regression analysis was performed to assess whether baseline BMI or treatment received was associated with this endpoint adjusting for known prognostic factors. Results. By the 6-month followup, 12 men gained ≥10 lbs, of which 10 (83%) received RT + ADT and, of these, 7 (70%) were obese at randomization. Men treated with RT as compared to RT + ADT were less likely to gain ≥10 lbs (adjusted odds ratio (AOR): 0.18 [95% CI: 0.04-0.89]; P = 0.04), whereas this risk increased with increasing BMI (AOR: 1.15 [95% CI: 1.01-1.31]; P = 0.04). Conclusions. Consideration should be given to avoid ADT in obese men with low- or favorable-intermediate risk PC where improved cancer control has not been observed, but shortened life expectancy from weight gain is expected.
authors.affiliation: Harvard Radiation Oncology Program, Brigham and Women's Hospital, ASB-I Radiation Oncology L2, 75 Francis Street, Boston, MA 02115, USA.
authors.forename: Lior Z
authors.initials: LZ
authors.lastname: Braunstein
authors.affiliation: Department of Statistics, University of Connecticut, 215 Glenbrook Road, U-4120, Storrs, CT 06269-4120, USA.
authors.forename: Ming-Hui
authors.initials: MH
authors.lastname: Chen
authors.affiliation: Lank Center for Genitourinary Oncology, Dana-Farber Cancer Institute, Mailstop Dana 1230, 450 Brookline Avenue, Boston, MA 02215, USA ; Department of Radiation Oncology, Dana-Farber/Brigham and Women's Hospital, ASB-I Radiation Oncology L2, 75 Francis Street, Boston, MA 02115, USA.
authors.forename: Marian
authors.initials: M
authors.lastname: Loffredo
authors.affiliation: Lank Center for Genitourinary Oncology, Dana-Farber Cancer Institute, Mailstop Dana 1230, 450 Brookline Avenue, Boston, MA 02215, USA.
authors.forename: Philip W
authors.initials: PW
authors.lastname: Kantoff
authors.affiliation: Lank Center for Genitourinary Oncology, Dana-Farber Cancer Institute, Mailstop Dana 1230, 450 Brookline Avenue, Boston, MA 02215, USA ; Department of Radiation Oncology, Dana-Farber/Brigham and Women's Hospital, ASB-I Radiation Oncology L2, 75 Francis Street, Boston, MA 02115, USA.
authors.forename: Anthony V
authors.initials: AV
authors.lastname: D'Amico