Radiotherapy and Short-Term Androgen Deprivation for Localized Prostate Cancer

Abstract

Among patients with stage T1b, T1c, T2a, or T2b prostate adenocarcinoma and a PSA level of 20 ng per milliliter or less, the use of short-term ADT for 4 months before and during radiotherapy was associated with significantly decreased disease-specific mortality and increased overall survival. According to post hoc risk analysis, the benefit was mainly seen in intermediate-risk, but not low-risk, men. (Funded by the National Cancer Institute; RTOG 94-08 ClinicalTrials.gov number, NCT00002597.).

Therapeutic outcomes of neoadjuvant and concurrent androgen‐deprivation therapy and intensity‐modulated radiation therapy with gold marker implantation for intermediate‐risk and high‐risk prostate cancer

“…The use of long-term hormone therapy in combination with conventional doses (65-70 Gy) of external beam radiation therapy has been shown to contribute to improved therapeutic outcomes in patients with localized prostate cancer, particularly those at high risk, whereas short-term neoadjuvant hormone therapy is believed to contribute to improved therapeutic outcomes in patients at moderate risk. [17][18][19][20][21][22][23][24] However, the evidence for these indications is based on radiation doses of 65-70 Gy, and the value of ADT in combination with !76 Gy radiation doses remains unclear. Opinions on this point are divided, as some studies have found no association between ADT and therapeutic outcomes of !76 Gy IMRT, whereas others have reported improved DMFS.…”

EAU-ESTRO-SIOG Guidelines on Prostate Cancer. Part 1: Screening, Diagnosis, and Local Treatment with Curative Intent

“…Patients suitable for ADT should be given combined doseescalated IMRT (76-78 Gy) with short-term ADT (4-6 months) [68]. For patients unsuitable for ADT (e.g.…”

Current trends for the use of androgen deprivation therapy in conjunction with radiotherapy for patients with unfavorable intermediate‐risk, high‐risk, localized, and locally advanced prostate cancer

“…The evidence for short-term NHT plus RT compared with RT alone is supported by several studies. [4][5][6][7][8] In the RTOG 86-10 trial, the combination of goserelin plus flutamide for 2 months before RT and concurrent with RT was evaluated in patients with locally advanced PCa (bulky T2-4 tumors with or without pelvic lymph node involvement). 29 NHT significantly improved diseasespecific survival versus the use of RT alone.…”

“…1). 6 Two randomized controlled trials (RCTs) demonstrated that 6 months of NHT also improved OS compared with RT alone. 4,5 In the first study, the addition of 6 months of NHT/concurrent/adjuvant ADT to RT also conferred an OS benefit versus RT alone.…”