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ADT in Combination with Radiation Therapy for Clinically Localized Prostate Cancer

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Hormone Therapy and Castration Resistance of Prostate Cancer

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Abstract

External beam radiotherapy (EBRT) is a well-established definitive therapeutic approach for clinically localized prostate cancer (CLPCa). Although CLPCa had been mainly treated with EBRT alone, androgen deprivation therapy (ADT) has been shown to improve not only biochemical control but also survival outcomes when combined with EBRT.

Adding ADT to EBRT using former standard doses (65–70 Gy) significantly improved survival outcomes compared with EBRT alone in patients with intermediate- or high-risk disease. Therefore, ADT is considered to be an essential element in definitive EBRT for most cases of CLPCa.

In terms of intermediate-risk patients, the neoadjuvant combination of ADT for a period of 4–6 months combined with EBRT is recommended. On the other hand, for high- or very-high-risk patients, neoadjuvant ADT for 4–6 months followed by adjuvant ADT for 24–30 months is considered to be the standard treatment for use in combination with EBRT.

However, the optimal duration of ADT in combination with EBRT remains controversial. In addition, the usefulness of ADT is controversial when combined with dose-escalated EBRT. Moreover, ethnic differences in patient sensitivity to ADT have been suggested. Randomized trials are required to clear up these unsolved issues regarding ADT combined with EBRT.

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Authors and Affiliations

  1. Department of Radiation Oncology and Image-applied Therapy, Kyoto University Graduate School of Medicine, Kyoto, Japan

    Takashi Mizowaki M.D. Ph.D.

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  1. Takashi Mizowaki M.D. Ph.D.
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Correspondence to Takashi Mizowaki M.D. Ph.D. .

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  1. Department of Urology, Tohoku University School of Medicine, Sendai, Japan

    Yoichi Arai

  2. Department of Urology, Kyoto University Graduate School of Medicine, Kyoto, Japan

    Osamu Ogawa

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Mizowaki, T. (2018). ADT in Combination with Radiation Therapy for Clinically Localized Prostate Cancer. In: Arai, Y., Ogawa, O. (eds) Hormone Therapy and Castration Resistance of Prostate Cancer. Springer, Singapore. https://doi.org/10.1007/978-981-10-7013-6_12

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  • DOI: https://doi.org/10.1007/978-981-10-7013-6_12

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