{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T01:37:03Z","timestamp":1789522623707,"version":"build-2803163510"},"reference-count":29,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"9","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["JCO Oncol Pract"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:sec>\n                    <jats:title>PURPOSE<\/jats:title>\n                    <jats:p>The 2022 AUA\/ASTRO guidelines recommend 18-36 months of androgen deprivation therapy (ADT) with definitive radiotherapy for localized, high-risk prostate cancer. The STAMPEDE M0 trial supports intensification with androgen receptor pathway inhibitors (ARPIs) for patients with \u22652 cT3\/T4, Grade Group [GG] 4-5, prostate-specific antigen (PSA) \u226540 ng\/mL, or cN1. Given advances in imaging, risk stratification, and treatment delivery, we characterized contemporary practice patterns using prospective data from the Michigan Radiation Oncology Quality Consortium (MROQC).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>Patients enrolled in MROQC with intact, high-risk M0\/N0-1 prostate cancer were included. Clinical information, including intended ADT duration and ARPI use, was prospectively collected. The primary outcome was intended guideline-concordant ADT (GC-ADT, \u226518 months). Multivariable analyses (MVA) assessed associations between clinical factors and GC-ADT recommendations. We compared the adoption of ARPI with standard therapies before and after the publication of STAMPEDE M0. Facility-level variability was evaluated using a mixed-effects model, with the treatment site as a random intercept.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>\n                      Between June 2020 and November 2024, 553 patients across 26 centers were included: cT3\/4 (13.3%), cN1 (19.9%), GG 4-5 (75.0%), and PSA \u226520 ng\/mL (40.0%). Overall, 91.3% were recommended ADT, with 67.0% being guideline-concordant. On MVA, GC-ADT was significantly associated with cN1 (odds ratio [OR], 2.94 [95% CI, 1.44 to 5.99]), GG (GG4 OR, 6.23 [95% CI, 2.85 to 13.62]; GG5 OR, 9.45 [95% CI, 4.46 to 20.06]), and PSA \u226540 (OR, 3.64 [95% CI, 1.22\u201310.87]). Facility-level variability persisted in the MVA (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .0001). Among the 27.9% who met meeting STAMPEDE criteria, ARPI recommendations increased from 0% prepublication to 23.2% afterward.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>Within a statewide quality consortium, guideline-concordant ADT recommendations occurred in two thirds of patients, with ARPI intensification in under 25% among STAMPEDE-eligible patients. These findings highlight the need for individualized ADT strategies and collaborative efforts to standardize high-quality care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1200\/op-25-00489","type":"journal-article","created":{"date-parts":[[2025,9,26]],"date-time":"2025-09-26T19:59:10Z","timestamp":1758916750000},"page":"1590-1598","update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":2,"title":["Androgen Deprivation Therapy Practice Patterns in High-Risk Prostate Cancer Treated With Definitive Radiotherapy: Prospective Results From a Statewide Quality Consortium"],"prefix":"10.1200","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0834-7669","authenticated-orcid":true,"given":"Michael P.","family":"Dykstra","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology, University of Michigan, Ann Arbor, MI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel 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MI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3222-9849","authenticated-orcid":true,"given":"Melissa","family":"Mietzel","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, University of Michigan, Ann Arbor, MI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7080-3488","authenticated-orcid":true,"given":"David K.","family":"Heimburger","sequence":"additional","affiliation":[{"name":"Munson Healthcare, Traverse City, MI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Schipper","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, University of Michigan, Ann Arbor, MI"},{"name":"Department of Biostatistics, University of Michigan, Ann Arbor, MI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8709-5978","authenticated-orcid":true,"given":"William 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