Skip to main content
SpringerLink
Log in

Androgen Deprivation and Radiation Therapy for Localized Prostate Cancer

  • Chapter
Management of Prostate Cancer

Part of the book series: Current Clinical Urology ((CCU))

  • 177 Accesses

Abstract

The combination of hormonal therapy (HT) with radiation therapy (RT) to treat localized prostate cancer, particularly locally advanced prostate cancers, has substantially increased in recent years. The optimal use of HT, which is constantly expanding, is still to be determined. Fortunately, multiple prospective studies performed since the 1980s have shed some light on many questions related to the use of HT in combination with RT. This chapter reviews the data and the findings from these prospective studies, although relevant retrospective data are also discussed.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 74.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Davies-Johns T, Reddy C, Kupelian P. Localized prostate cancer treated with radiotherapy: who benefits from hormonal therapy? Int J Radiat Oncol Biol Phys 2000; 48: 170.

    Article  Google Scholar 

  2. Consensus statement: guidelines for PSA following radiation therapy. American Society for Therapeutic Radiology and Oncology Consensus Panel. Int J Radiat Oncol Biol Phys 1997;37:1035–1041.

    Google Scholar 

  3. D’Amico AV, Schultz D, Loffredo M, et al. Biochemical outcome following external beam radiation therapy with or without androgen suppression therapy for clinically localized prostate cancer. JAMA 2000; 284: 1280–1283.

    Article  PubMed  Google Scholar 

  4. Zagars GK, Johnson DE, von Eschenbach AC, et al. Adjuvant estrogen following radiation therapy for stage C adenocarcinoma of the prostate: long-term results of a prospective randomized study. Int J Radiat Oncol Biol Phys 1988; 14: 1085–1091.

    Article  PubMed  CAS  Google Scholar 

  5. Fellows GJ, Clark PB, Beynon LL, 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: 304–309.

    PubMed  CAS  Google Scholar 

  6. Grantors T, Modig H, Damber JE, Tomic K. Combined orchiectomy and external radiotherapy versus radiotherapy alone for nonmetastatic prostate cancer with or without pelvic lymph node involvement: a prospective randomized study. J Urol 1998; 159: 2030–2034.

    Article  Google Scholar 

  7. Pilepich MV, Caplan R, Byhardt RW, et al. Phase III trial of androgen suppression using goserelin in unfavorable-prognosis carcinoma of the prostate treated with definitive radiotherapy: report of Radiation Therapy Oncology Group Protocol 85–31. J Clin Oncol 1997; 15: 1013–1021.

    PubMed  CAS  Google Scholar 

  8. Lawton CA, Winter K, Murray K, et al. Updated results of the phase III Radiation Therapy Oncology Group (RTOG) trial 85–31 evaluating the potential benefit of androgen suppression following standard radiation therapy for unfavorable prognosis carcinoma of the prostate. Int J Radiat Oncol Biol Phys 2001; 49: 937–946.

    Article  PubMed  CAS  Google Scholar 

  9. Bolla M, Collette L, Blank L, et al. Long-term results with immediate androgen suppression and external irradiation in patients with locally advanced prostate cancer (an EORTC study): a phase III randomised trial. Lancet 2002; 360: 103–106.

    Article  PubMed  CAS  Google Scholar 

  10. Bolla M, Gonzalez D, Warde P, et al. Improved survival in patients with locally advanced prostate cancer treated with radiotherapy and goserelin. N Engl J Med 1997; 337: 295–300.

    Article  PubMed  CAS  Google Scholar 

  11. Pilepich MV, Winter K, John MJ, 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: 1243–1252.

    Article  PubMed  CAS  Google Scholar 

  12. Hanks GE, Lu JD, Machtay M, et al. RTOG protocol 92–02: a phase III trial of the use of long term total androgen supression following neoadjuvant hormonal cytoreduction and radiotherapy in locally advanced carcinoma of the prostate. Int J Radiat Oncol Biol Phys 2000; 48: 112.

    Article  Google Scholar 

  13. Roach M 3rd, DeSilvio M, Lawton C, et al. Phase III trial comparing whole-pelvic versus prostate-only radiotherapy and neoadjuvant versus adjuvant combined androgen suppression: Radiation Therapy Oncology Group 9413. J Clin Oncol 2003; 21: 1904–1911.

    Article  PubMed  Google Scholar 

  14. Joon DL, Hasegawa M, Sikes C, et al. Supraadditive apoptotic response of R3327-G rat prostate tumors to androgen ablation and radiation. Int J Radiat Oncol Biol Phys 1997; 38: 1071–1077.

    Article  PubMed  CAS  Google Scholar 

  15. Zietman AL, Prince EA, Nakfoor BM, et al. Androgen deprivation and radiation therapy: sequencing studies using the Shionogi in vivo tumor system. Int J Radiat Oncol Biol Phys 1997; 38: 1067–1070.

    Article  PubMed  CAS  Google Scholar 

  16. Pollack A, Zagars GK, Starkschall G, et al. Prostate cancer radiation dose response: results of the M. D. Anderson phase III randomized trial. Int J Radiat Oncol Biol Phys 2002; 53: 1097–1105.

    Article  PubMed  Google Scholar 

  17. Hanks GE, Hanlon AL, Pinover WH, et al. Dose selection for prostate cancer patients based on dose comparison and dose response studies. Int J Radiat Oncol Biol Phys 2000; 46: 823–832.

    Article  PubMed  CAS  Google Scholar 

  18. Zelefsky MJ, Leibel SA, Gaudin PB, et al. Dose escalation with three-dimensional conformal radiation therapy affects the outcome in prostate cancer. Int J Radiat Oncol Biol Phys 1998; 41: 491–500.

    Article  PubMed  CAS  Google Scholar 

  19. Lyons JA, Kupelian PA, Mohan DS, et al. Importance of high radiation doses (72 Gy or greater) in the treatment of stage T1–T3 adenocarcinoma of the prostate. Urology 2000; 55: 85–90.

    Article  PubMed  CAS  Google Scholar 

  20. Kupelian PA, Buchsbaum JC, Elshaikh M, et al. Factors affecting recurrence rates after prostatectomy or radiotherapy in localized prostate carcinoma patients with biopsy Gleason score 8 or above. Cancer 2002; 95: 2302–2307.

    Article  PubMed  Google Scholar 

  21. Buchsbaum J, Elshaikh M, Kupelian P, et al. Improvement in relapse-free survival throughout the PSA era in patients with localized prostate cancer treated with definitive radiotherapy: year of treatment is an independent predictor of outcome. Int J Radiat Oncol Biol Phys 2001; 51; 169: 169.

    Article  Google Scholar 

  22. Jhaveri FM, Klein EA, Kupelian PA, et al. Declining rates of extracapsular extension after radical prostatectomy: evidence for continued stage migration. J Clin Oncol 1999; 17: 3167–3172.

    PubMed  CAS  Google Scholar 

  23. See WA, Wirth MP, McLeod DG, et al. Bicalutamide as immediate therapy either alone or as adjuvant to standard care of patients with localized or locally advanced prostate cancer: first analysis of the early prostate cancer program. J Urol 2002; 168: 429–435.

    Article  PubMed  CAS  Google Scholar 

  24. Soloway MS, Pareek K, Sharifi R, et al. Neoadjuvant androgen ablation before radical prostatectomy in cT2bNxMo prostate cancer: 5-year results. J Urol 2002; 167: 112–116.

    Article  PubMed  Google Scholar 

  25. Soloway MS, Sharifi R, Wajsman Z, et al. Randomized prospective study comparing radical prostatectomy alone versus radical prostatectomy preceded by androgen blockade in clinical stage B2 (T2bNxM0) prostate cancer. The Lupron Depot Neoadjuvant Prostate Cancer Study Group. J Urol 1995; 154: 424–428.

    Article  PubMed  CAS  Google Scholar 

  26. Klotz LH, Goldenberg SL, Jewett M, et al. CUOG randomized trial of neoadjuvant androgen ablation before radical prostatectomy: 36-month post-treatment PSA results. Canadian Urologic Oncology Group. Urology 1999; 53: 757–763.

    Article  PubMed  CAS  Google Scholar 

  27. Gleave ME, Goldenberg SL, Chin JL, et al. Randomized comparative study of 3 versus 8-month neoadjuvant hormonal therapy before radical prostatectomy: biochemical and pathological effects. J Urol 2001;166:500–506; discussion 506–507.

    Google Scholar 

  28. Shipley WU, Lu JD, Pilepich MV, et al. Effect of a short course of neoadjuvant hormonal therapy on the response to subsequent androgen suppression in prostate cancer patients with relapse after radiotherapy: a secondary analysis of the randomized protocol RTOG 86–10. Int J Radiat Oncol Biol Phys 2002; 54: 1302–1310.

    Article  PubMed  CAS  Google Scholar 

  29. Martinez AA, Yan D, Lockman D, et al. Improvement in dose escalation using the process of adaptive radiotherapy combined with three-dimensional conformal or intensity-modulated beams for prostate cancer. Int J Radiat Oncol Biol Phys 2001; 50: 1226–1234.

    Article  PubMed  CAS  Google Scholar 

  30. Zelefsky MJ, Fuks Z, Hunt M, et al. High-dose intensity modulated radiation therapy for prostate cancer: early toxicity and biochemical outcome in 772 patients. Int J Radiat Oncol Biol Phys 2002; 53: 1111–1116.

    Article  PubMed  Google Scholar 

  31. Kupelian PA, Buchsbaum JC, Reddy CA, et al. Radiation dose response in patients with favorable localized prostate cancer (stage T1–T2, biopsy Gleason or = 6, and pretreatment prostate-specific antigen or = 10). Int J Radiat Oncol Biol Phys 2001; 50: 621–625.

    Article  PubMed  CAS  Google Scholar 

  32. Kupelian PA, Willoughby TR. Short-course, intensity-modulated radiotherapy for localized prostate cancer. Cancer J 2001; 7: 421–426.

    PubMed  CAS  Google Scholar 

  33. Kupelian PA, Mohan DS, Lyons J, et al. Higher than standard radiation doses (72 Gy or greater) with or without androgen deprivation in the treatment of localized prostate cancer. Int J Radiat Oncol Biol Phys 2000; 46: 567–574.

    Article  PubMed  CAS  Google Scholar 

  34. Kupelian PA. Improvement in overall survival for patients with localized prostate cancer with higher than standard radiation doses: preliminary results. J Urol 1999; 161: 386.

    Article  Google Scholar 

  35. Hanks GE, Hanlon AL, Pinover WH, et al. Survival advantage for prostate cancer patients treated with high-dose three-dimensional conformal radiotherapy. Cancer J Sci Am 1999; 5: 152–158.

    PubMed  CAS  Google Scholar 

Download references

Authors
  1. Patrick A. Kupelian
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Tom Carlson
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Section of Urology Oncology, Glickman Urological Institute, Cleveland Clinic Foundation, Cleveland, OH, USA

    Eric A. Klein MD (Head) (Head)

Rights and permissions

Reprints and permissions

Copyright information

© 2004 Springer Science+Business Media New York

About this chapter

Cite this chapter

Kupelian, P.A., Carlson, T. (2004). Androgen Deprivation and Radiation Therapy for Localized Prostate Cancer. In: Klein, E.A. (eds) Management of Prostate Cancer. Current Clinical Urology. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-59259-776-5_17

Download citation

  • DOI: https://doi.org/10.1007/978-1-59259-776-5_17

  • Publisher Name: Humana Press, Totowa, NJ

  • Print ISBN: 978-1-4757-5711-8

  • Online ISBN: 978-1-59259-776-5

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation