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“Optimizing Hormone Therapy in Localized Prostate Cancer: Focus on External Beam Radiotherapy”
SANDLER, HOWARD M. Journal of Urology. Innovations and Challenges in Prostate Cancer: Prevention, Detection and Treatment: Fourth International Conference. 172(5, Part 2 of 2) Supplement:S38-S41, November 2004.
The purpose of this study was to
evaluate the use of hormone
therapy when combined with radiotherapy
prior to a radical
prostatectomy. Physicians analyzed ongoing clinical
trials in an effort to identify prostate cancer patients
who will benefit most from this combination. In patients
with low Gleason scores, short-term androgen ablation
improved cause specific survival rates. For high-grade
prostate cancer, long-term androgen ablation is required.
Patients at intermediate risk are candidates for short-term
androgen ablation, however there is a lack of trials
that assess overall treatment benefit. Doctors advise
patients with low risk prostate cancer to not receive
androgen ablation unless additional data support a substantial
clinical benefit. Patients with a high-risk for pelvic
lymph
node involvement may receive whole
pelvic radiotherapy in order to maximize biochemical
interaction.
“Hormonal Therapy and Radiotherapy for Localized Prostate Cancer: Who, Where, and How Long?”
ROACH, MACK III Journal of Urology. 170(6, Part 2 of 2):S35-S41, December 2003.
In this study 1, 323 patients with
a risk of lymph node involvement greater than 15 percent
were analyzed to determine the success rate of hormone
therapy used with external beam radiation. Long-term
hormone therapy was tested against short-term. Doctors
compared whole pelvis radiotherapy, radiotherapy of
the prostate alone, neoadjuvant
and adjuvant hormone therapy with radiotherapy, and
radiotherapy with adjuvant hormone therapy. They strived
to find out which one out of the four would most improve
progression-free
survival. After five years, all four
treatments were contrasted and whole pelvis radiotherapy
as well as neoadjuvant and concurrent hormone therapy
with radiotherapy were found to be the best options
in the improvement of progression-free survival.
“Neoadjuvant Hormone Therapy Before Salvage Radiotherapy for an Increasing Post-radical Prostatectomy Serum Prostate Specific Antigen Level”
TIGUERT, RABI; RIGAUD, JEROME; LACOMBE, LOUIS; LAVERDIERE, JACQUES; FRADET, YVES Journal of Urology. 170(2, Part 1):447-450, August 2003.
Within this study doctors retrospectively
evaluated 81 patients who were treated with neoadjuvant
androgen deprivation therapy before salvage
external beam radiation treatment due to an increased
PSA
level following radical retropubic
prostatectomy.
Patients were analyzed based on the outcome of preoperative,
pathological, postoperative characteristics, pre-salvage
treatment, and radiation therapy. Prior to the salvage
radiotherapy patients received a 3-month injection of
a luteinizing
hormone releasing hormone analogue.
Doctors followed up with their patients approximately
38 months after external beam radiation and 91 months
after radical prostatectomy. At three years 75% of patients
were free of biochemical failure and 50% were at 5 years.
Two patients (2 percent) died of prostate cancer. Those
who benefited most from this treatment were patients
with a pre-radiation PSA level less than 1 and a Gleason
score less than 7.
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