Advertisement

The Roles of Radiotherapy, Androgen Deprivation Therapy, and Their Combination for Locally Advanced Prostate Cancer

  • Sung Uk Lee
  • Kwan Ho Cho
Chapter

Abstract

Men with locally advanced or high-risk prostate cancer have a substantial risk of dying and developing distant metastases. Historically, androgen deprivation therapy (ADT) by bilateral orchiectomy was frequently used as an effective systemic treatment for advanced prostate cancer. In the 1980s, luteinizing hormone-releasing hormone (LHRH) analogs and antiandrogens emerged and have been used as a medical castration alternative to bilateral orchiectomy. After its success as a palliative treatment for metastatic prostate cancer, a number of trials were initiated to investigate the role of radiotherapy (RT), ADT, and their combination in multimodal treatment for locally advanced or high-risk prostate cancer. In this chapter, we highlighted important randomized trials of combined therapy for locally advanced or high-risk prostate cancer and tried to define the individual roles of RT, ADT, and their combination. A comprehensive review of this topic has been published elsewhere [1], and a large part of the content has been duplicated.

References

  1. 1.
    Lee SU, Cho KH. Multimodal therapy for locally advanced prostate cancer: the roles of radiotherapy, androgen deprivation therapy, and their combination. J Radiat Oncol. 2017;35(3):189–97.CrossRefGoogle Scholar
  2. 2.
    Pilepich MV, Winter K, Lawton CA, Krisch RE, Wolkov HB, Movsas B, et al. Androgen suppression adjuvant to definitive radiotherapy in prostate carcinoma--long-term results of phase III RTOG 85-31. Int J Radiat Oncol Biol Phys. 2005;61(5):1285–90.CrossRefPubMedGoogle Scholar
  3. 3.
    Roach M 3rd, Bae K, Speight J, Wolkov HB, Rubin P, Lee RJ, et al. Short-term neoadjuvant androgen deprivation therapy and external-beam radiotherapy for locally advanced prostate cancer: long-term results of RTOG 8610. J Clin Oncol. 2008;26(4):585–91.CrossRefPubMedGoogle Scholar
  4. 4.
    Bolla M, Van Tienhoven G, Warde P, Dubois JB, Mirimanoff R-O, Storme G, et al. External irradiation with or without long-term androgen suppression for prostate cancer with high metastatic risk: 10-year results of an EORTC randomised study. Lancet Oncol. 2010;11(11):1066–73.CrossRefPubMedGoogle Scholar
  5. 5.
    Denham JW, Steigler A, Lamb DS, Joseph D, Turner S, Matthews J, et al. Short-term neoadjuvant androgen deprivation and radiotherapy for locally advanced prostate cancer: 10-year data from the TROG 96.01 randomised trial. Lancet Oncol. 2011;12(5):451–9.CrossRefPubMedGoogle Scholar
  6. 6.
    Pilepich MV, Winter K, John MJ, Mesic JB, Sause W, Rubin P, et al. Phase III radiation therapy oncology group (RTOG) trial 86-10 of androgen deprivation adjuvant to definitive radiotherapy in locally advanced carcinoma of the prostate. Int J Radiat Oncol Biol Phys. 2001;50(5):1243–52.CrossRefPubMedGoogle Scholar
  7. 7.
    McLaughlin PW, Liss AL, Nguyen PL, Assimos DG, D'Amico AV, Gottschalk AR, et al. ACR appropriateness criteria(R) locally advanced, high-risk prostate cancer. Am J Clin Oncol. 2017;40(1):1–10.CrossRefPubMedGoogle Scholar
  8. 8.
    Fellows GJ, Clark PB, Beynon LL, Boreham J, Keen C, Parkinson MC, et al. Treatment of advanced localised prostatic cancer by orchiectomy, radiotherapy, or combined treatment. A Medical Research Council Study. Urological Cancer Working Party--Subgroup on Prostatic Cancer. Br J Urol. 1992;70(3):304–9.CrossRefPubMedGoogle Scholar
  9. 9.
    Warde P, Mason M, Ding K, Kirkbride P, Brundage M, Cowan R, et al. Combined androgen deprivation therapy and radiation therapy for locally advanced prostate cancer: a randomised, phase 3 trial. Lancet. 2011;378(9809):2104–11.CrossRefPubMedPubMedCentralGoogle Scholar
  10. 10.
    Mason MD, Parulekar WR, Sydes MR, Brundage M, Kirkbride P, Gospodarowicz M, et al. Final report of the intergroup randomized study of combined androgen-deprivation therapy plus radiotherapy versus androgen-deprivation therapy alone in locally advanced prostate cancer. J Clin Oncol. 2015;33(19):2143–50.CrossRefPubMedPubMedCentralGoogle Scholar
  11. 11.
    Widmark A, Klepp O, Solberg A, Damber JE, Angelsen A, Fransson P, et al. Endocrine treatment, with or without radiotherapy, in locally advanced prostate cancer (SPCG-7/SFUO-3): an open randomised phase III trial. Lancet. 2009;373(9660):301–8.CrossRefPubMedGoogle Scholar
  12. 12.
    Mottet N, Peneau M, Mazeron JJ, Molinie V, Richaud P. Addition of radiotherapy to long-term androgen deprivation in locally advanced prostate cancer: an open randomised phase 3 trial. Eur Urol. 2012;62(2):213–9.CrossRefPubMedGoogle Scholar
  13. 13.
    Freedland SJ, Eastham J, Shore N. Androgen deprivation therapy and estrogen deficiency induced adverse effects in the treatment of prostate cancer. Prostate Cancer Prostatic Dis. 2009;12(4):333–8.CrossRefPubMedGoogle Scholar
  14. 14.
    Horwitz EM, Bae K, Hanks GE, Porter A, Grignon DJ, Brereton HD, et al. Ten-year follow-up of radiation therapy oncology group protocol 92-02: a phase III trial of the duration of elective androgen deprivation in locally advanced prostate cancer. J Clin Oncol. 2008;26(15):2497–504.CrossRefPubMedGoogle Scholar
  15. 15.
    Bolla M, de Reijke TM, Van Tienhoven G, Van den Bergh AC, Oddens J, Poortmans PM, et al. Duration of androgen suppression in the treatment of prostate cancer. N Engl J Med. 2009;360(24):2516–27.CrossRefPubMedGoogle Scholar
  16. 16.
    Morris WJ, Tyldesley S, Rodda S, Halperin R, Pai H, McKenzie M, et al. Androgen suppression combined with elective nodal and dose escalated radiation therapy (the ASCENDE-RT trial): an analysis of survival endpoints for a randomized trial comparing a low-dose-rate brachytherapy boost to a dose-escalated external beam boost for high- and intermediate-risk prostate cancer. Int J Radiat Oncol Biol Phys. 2017;98(2):275–85.CrossRefPubMedGoogle Scholar
  17. 17.
    Rodda S, Tyldesley S, Morris WJ, Keyes M, Halperin R, Pai H, et al. ASCENDE-RT: an analysis of treatment-related morbidity for a randomized trial comparing a low-dose-rate brachytherapy boost with a dose-escalated external beam boost for high- and intermediate-risk prostate cancer. Int J Radiat Oncol Biol Phys. 2017;98(2):286–95.CrossRefPubMedGoogle Scholar
  18. 18.
    Rodda S, Morris WJ, Hamm J, Duncan G. ASCENDE-RT: an analysis of health-related quality of life for a randomized trial comparing low-dose-rate brachytherapy boost with dose-escalated external beam boost for high- and intermediate-risk prostate cancer. Int J Radiat Oncol Biol Phys. 2017;98(3):581–9.CrossRefPubMedGoogle Scholar
  19. 19.
    James N, Mason M. Docetaxel and/or zoledronic acid for hormone-naïve prostate cancer: first survival results from STAMPEDE. J Clin Oncol. 2015;33(suppl):5001.Google Scholar
  20. 20.
    Sandler HM, Hu C, Rosenthal SA, et al. A phase III protocol of androgen suppression (AS) and 3DCRT/IMRT versus AS and 3DCRT/IMRT followed by chemotherapy (CT) with docetaxel and prednisone for localized, high-risk prostate cancer (RTOG 0521). J Clin Oncol. 2015;33(suppl):5002.CrossRefGoogle Scholar
  21. 21.
    Fizazi K, Tran N, Fein L, Matsubara N, Rodriguez-Antolin A, Alekseev BY, et al. Abiraterone plus prednisone in metastatic, castration-sensitive prostate cancer. N Engl J Med. 2017;377:352–60.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Nature Singapore Pte Ltd. 2018

Authors and Affiliations

  1. 1.The Proton Therapy Center, Research Institute and Hospital, National Cancer CenterIlsandong-guSouth Korea

Personalised recommendations