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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
hormone therapy and concurrent 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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