This review article describes clinical evidence of the benefits and risks of a treatment combined of a short course of hormonal therapy (termed ‘androgen deprivation therapy’, ADT) and radiation given in escalated doses. Patients involved were those with localized prostate cancer but higher Gleason score or prostate-specific antigen (PSA) values (herein termed ‘intermediate risk factors’).
After analyzing the results of various trials, the authors found two clinical trials reporting increased overall survival when short-term ADT was added to low-dose radiotherapy. Current standard of care, however, uses higher doses of radiotherapy, thus limiting the applicability of these studies into common practice. Moreover, other factors, such as the variable tumor response to treatment, as well as possible side effects of ADT may affect a clinician’s decision when choosing the right treatment for localized, intermediate risk, prostate cancer.
To summarize this review, the authors recommend using an individualized approach for treatment selection, based on the clinical characteristics of each patient. This involves using radiotherapy alone for patients having only one intermediate risk factor, a Gleason score of 7 or less, and <50% positive biopsy cores. However, they recommend adding short-term ADT to dose-escalated radiotherapy for patients having several intermediate-risk factors, a Gleason score >7, and at least 50% positive biopsy cores.
Published By :
Lancet oncology
Date :
Jun 01, 2012
