Comparative Analysis of PSA Nadir and Time to PSA Nadir on Clinical Outcomes in Patients with De Novo Spine Metastasis of Prostate Cancer Undergoing Androgen Deprivation Treatment (ADT) Only vs. ADT Intensification

Abstract

Background Metastatic prostate cancer, particularly with bone involvement, is a severe form of the disease associated with poor prognosis. Androgen deprivation therapy (ADT) has been the standard treatment, but recent strategies suggest that ADT intensification may improve outcomes. This study evaluates the impact of ADT intensification on prostate-specific antigen (PSA) Nadir, time to PSA Nadir, and clinical outcomes in patients with de novo spine metastasis of prostate cancer. Methods A comparative study was conducted at Nkwen Baptist Hospital involving patients with de novo spine metastasis of prostate cancer. Patients were divided into two groups: those receiving ADT only and those receiving ADT intensification. Key outcomes measured included PSA Nadir levels, time to PSA Nadir, progression-free survival (PFS), and overall survival (OS). Results The ADT intensification group had significantly lower PSA Nadir levels (0.13 ng/mL vs. 0.27 ng/mL) and shorter TTPN(1 month vs. 6 months) compared to the ADT only group. The median PFS was markedly longer in the ADT intensification group (59.198 months vs. 23.029 months), although the difference in OS did not reach statistical significance. Improved performance status was observed in the ADT intensification group without significant differences in adverse events. Conclusion ADT intensification leads to improved PSA Nadir levels, quicker time to Nadir, and significantly longer PFS in patients with de novo spine metastasis of prostate cancer. These findings support the use of ADT intensification as a treatment strategy to enhance clinical outcomes and patient quality of life.