Androgen Deprivation Therapy in the Treatment of Locally Advanced, Nonmetastatic Prostate Cancer: Practical Experience and a Review of the Clinical Trial Evidence

Overview

Journal Ther Adv Urol

Publisher Sage Publications

Date 2017 Apr 11

PMID 28392836

Citations 7

Authors

Fouad Aoun

Ali Bourgi

Elias Ayoub

Elie El Rassy

Roland van Velthoven

Alexandre Peltier

Affiliations

Soon will be listed here.

Abstract

Following new scientific insights, initial management for patients with high-risk nonmetastatic prostate cancer has changed considerably and rapidly over the last few years. Several clinical and pathologic variables should be taken into account when deciding the best treatment choice for those patients. These variables are summarized and discussed in detail. High radiation doses to the prostate are essential to achieve good local control in patients with high-risk nonmetastatic disease. Addition of androgen deprivation therapy (ADT) to radiation therapy has significantly improved overall survival and cancer-specific survival compared with radiation therapy alone without significantly increasing toxicity. Long-term neo(adjuvant) ADT (2-3 years) to radiation therapy significantly improved cancer-specific survival compared with short-term ADT (4-6 months). Radical prostatectomy with extended pelvic lymph node dissection is considered a reasonable option in experienced hands. ADT alone is an inappropriate treatment option for patients with high-risk nonmetastatic disease. Management decisions for these patients should be discussed by a multidisciplinary team.

Citing Articles

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