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Hormone treatment combined with radiotherapy
Oncology 12
Hormones + Radiotherapy – Locally Advanced Prostate Cancer – T3/T4
Traditionally, single modality treatment for locally advanced and high risk prostate cancer patients results in high failure rate
Hormones + Radiotherapy – Locally Advanced Prostate Cancer – T3/T4
Hormones + Radiotherapy – Locally Advanced Prostate Cancer – T3/T4
Short Term Neoadjuvant + Radiotherapy RTOG 86-10
Roach, M. et al. J Clin Oncol; 26:585-591 2008
Overall survival
Short Term Neoadjuvant + Radiotherapy RTOG 86-10
Roach, M. et al. J Clin Oncol; 26:585-591 2008
Overall survival
Hormones + Radiotherapy – Locally Advanced Prostate Cancer – T3/T4
Adjuvant + Radiotherapy RTOG 85-31
Pilepich et al. Int J Rad Oncol Biol Phys 2005; 61:1285
Overall survival
Adjuvant + Radiotherapy RTOG 85-31
Pilepich et al. Int J Rad Oncol Biol Phys 2005; 61:1285
Overall survival
Hormones + Radiotherapy – Locally Advanced Prostate Cancer – T3/T4
Concurrent + Adjuvant + Radiotherapy EORTC 22863
Bolla M et al. Int J Rad Oncol Bio Phys 2008;72 Bolla M et al. Lancet 2010
Concurrent + Adjuvant + Radiotherapy EORTC 22863
Bolla M et al. Int J Rad Oncol Bio Phys 2008;72 Bolla M et al. Lancet 2010
Hormones + Radiotherapy – Locally Advanced Prostate Cancer – T3/T4
Neoadjuvant + Adjuvant + Radiotherapy RTOG 92-02
Hanks GE et al. J Clin Oncol 2008; 21:3972
Overall survival
Disease Free Survival
Hormones + Radiotherapy – Locally Advanced Prostate Cancer – T3/T4
What Should be the Duration of Hormone Therapy?
Hormones + Radiotherapy – Locally Advanced Prostate Cancer – T3/T4
Duration of Hormone Treatment
Overall Survival
Cardiac Event Mortality
Bolla M et al. NEJM 2009;360:2516
Duration of Hormone Treatment
Bolla M et al. NEJM 2009;360:2516
Quality of Life
Sexual ActivityDecreased Libido
Insomnia Hot Flashes
EAU Guidelines 2014
• minimum dose of > 74 Gy is recommended for EBRT + hormone therapy