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Locally advanced prostate cancer: combination of high-dose high-precision radiotherapy and androgen deprivation therap
Michel Bolla1,René-Olivier Mirimanoff2
1Department of Radiation Therapy and OncoloGy, Albert Michallon University Hospital, Grenoble, France(Michel Bolla; Email:MBolla@chu-grenoble.fr);2Radiation Oncology Center, La Source Hospital, Lausanne, Switzerland(René-Olivier Mirimanoff; Email: Rene-Olivier.Mirimanoff@chuv.ch)
Abstract：Locally advanced prostate cancer entails a risk of local, regional and systemic relapse requiring the combination of a loco-regional treatment, namely external beam radiotherapy(EBRT) to control the pelvic-confined disease, combined with a systemic therapy, namely androgen-deprivation therapy(ADT), to potentiate irradiation and to destroy the infra-clinical androgen-dependant disease outside the irradiated volume. Many phases III randomized trials have paved the way in establishing the indications of this combined approach, which requires a long term ADT(≥2 years) with LHRH agonists. The duration of ADT may be reduced to 6 months should there be a significant comorbidity, a reluctance from the patient or a poor tolerance. A multidisciplinary approach will enable physicians to tailor the treatment strategy and a close cooperation between the specialists and the general practitioners will be set up to prevent as much as possible the side-effects of ADT.
Michel Bolla,René-Olivier Mirimanoff. Locally advanced prostate cancer: combination of high-dose high-precision radiotherapy and androgen deprivation therap[J]. Chinese Journal of Radiation Oncology, 2014, 23(6): 463-467.
[1] Scardino PT, Abbas F, Adolfson J. Management of localized and regional diseases[A]//Denis K, Bartsch G, Khoury S, et al. Prostate cancer: the 3rd international consultation on prostate cancer[M]. Paris:Health Publications,2003:219-247. [2] Schroder FH, Hugosson J, Roobol MJ, et al. Screening and prostate-cancer mortality in a randomized European study[J]. N Engl J Med,2009,360:1320-1328. [3] Zelefsky MJ, Yamada Y, Kollmeier MA, et al. Long-term outcome following three-dimensional conformal/intensity-modulated external-beam radiotherapy for clinical stage T3 prostate cancer[J]. Eur Urol,2008,53:1172-1179. [4] Heidenreich A, Bellmunt J, Bolla M, et al. EAU guidelines on prostate cancer. Part 1: screening, diagnosis, and treatment of clinically localised disease[J]. Eur Urol,2011,59:61-71. [5] Schrder FH. What is new in endocrine therapy of prostatic cancer? EORTC genitourinary group monograph 7[A]//Newling DWW, Jones WG. Prostate cancer and testicular cancer[M]. New York: Wiley-Liss,1990:45-52. [6] Zietman AL, Prince EA, Nakfoor BM. Androgen deprivation and radiation therapy: sequencing studies using the Shionogi in vivo tumor system[J]. Int J Radiat Oncol Biol Phys,1997,38:1067-1070. [7] Joon DL, Hasegawa M, Sikes C, et al. Supraadditive apoptotic response of R3327-G rat prostate tumors to androgen ablation and radiation[J]. Int J Radiat Oncol Biol Phys,1997,38:1071-1077. [8] Kaminski JM, Hanlon AL, Joon DL, et al. Effect of sequencing of androgen deprivation and radiotherapy on prostate cancer growth[J]. Int J Radiat Oncol Biol Phys,2003,57:24-28. [9] Bolla M, Gonzalez D, Warde P, et al. Improved survival in patients with locally advanced prostate cancer treated with radiotherapy and goserilin[J]. N Engl J Med,1997,337:295-300. [10] 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[J]. Lancet,2002,360:103-106. [11] Bolla M, van Tienhoven G, Warde P, et al. External irradiation with or without long-term androgen suppression for prostate cancer with high metastatic risk: 10-year results of an EORTC randmized study[J]. Lancet Oncol,2010,11:1066-1073. [12] Pilepich MV, Winter K, Lawton CA, et al. Androgen suppression adjuvant to definitive radiotherapy in prostate carcinoma—long-term results of phase III RTOG 85-31[J]. Int J Radiat Oncol Biol Phys,2005,61:1285-1290. [13] Lawton CA, Winter K, Byhardt R, et al. Androgen suppression plus radiation versus radiation alone for patients with D1 (pN+) adenocarcinoma of the prostate (results based on a national prospective randomized trial, RTOG 85-31). Radiation Therapy Oncology Group[J]. Int J Radiat Oncol Biol Phys,1997,38:931-939. [14] Widmark A, Klepp O, Solberg A, et al. Endocrine treatment, with or without radiotherapy, in locally advanced prostate cancer (SPCG-7/SFUO-3): an open randomised phase III trial[J]. Lancet,2009,373:301-308 [15] Warde PR, Mason MD, Sydes MR, et al. Intergroup randomized phase III study of androgen deprivation therapy (ADT) pus radiation therapy (RT) in locally advanced prostate cancer (CaP)(NCIC-CTG, SWOG, MRC-UK,INT:T94-0110;NCT00002633)[J].Proc Am Soc Clin Oncol,2010,28:abstr CRA4504. [16] Hanks GE, Pajak TF, Porter A, et al. Phase III trial of long-term adjuvant androgen deprivation after neoadjuvant hormonal cytoreduction and radiotherapy in locally advanced carcinoma of the prostate: the Radiation Therapy Oncology Group Protocol 92-02[J]. J Clin Oncol,2003,21:3972-3978. [17] Horwitz EM, Bae K, Hanks GE, 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]. J Clin Oncol,2008,26:2497-2504. [18] Bolla M, de Reijke TM, Van Tienhoven G, et al. Duration of androgen suppression in the treatment of prostate cancer[J]. N Engl J Med,2009,360:2516-2527 [19] Barry MJ, Gallagher PM, Skinner JS, et al. Adverse effects of robotic-assisted laparoscopic versus open retropubic radical prostatectmoy among a nationwide random sample of Medicare-age men[J]. J Clin Oncol,2012,30:513-518. [20] Kuban DA, Tucker SL, Dong L, et al. Long-term results of the M. D. Anderson randomized dose-escalation trial for prostate cancer[J]. Int J Radiat Oncol Biol Phys,2008,70:67-74 [21] Viani GA, Stefano EJ, Afonso SL. Higher-than-conventional radiation doses in localized prostate cancer treatment: a meta analysis of randomized, controlled trials[J]. Int J Radiat Oncol Biol Phys,2009,74:1405-1418. [22] Kupelian PA, Ciezki J, Chandana AR, et al. Effect of increasing radiation doses on local and distant failures in patients with localized prostate cancer[J]. Int J Radiat Oncol Biol Phys,2008,71:16-22. [23] Zapatero A, Valcarcel F, Calvo FA, et al. Risk-adapted androgen deprivation and escalated three-dimensional conformal radiotherapy for prostate cancer: does radiation dose influence outcome of patients treated with adjuvant androgen deprivation? A GICOR study[J]. J Clin Oncol,2005,23:6561-6568. [24] Pommier P, Chabaud S, Lagrange JL, et al. Is there a role for pelvic irradiation in localized prostate adenocarcinoma? Preliminary results of GETUG-01[J]. J Clin Oncol,2007,25:5366-5373. [25] Lawton CA, Michalski J, El-Naqa I, et al. Variation in the definition of clinical target volumes for pelvic nodal conformal radiation therapy for prostate cancer[J]. Int J Radiat Oncol Biol Phys,2009,74:377-382. [26] Lawton CA, Michalski J, El-Naqa I, et al. RTOG GU Radiation Oncology specialists reach consensus on pelvic lymph node volumes for high-risk prostate cancer[J]. Int J Radiat Oncol Biol Phys,2009,74:383-387. [27] Milas L, Milas MM, Mason KA. Combination of taxanes with radiation: preclinical studies[J]. Semin Radiat Oncol,1999,9:12-26. [28] Schiff PB, Fant J, Horwitz SB. Promotion of microtubule assembly in vitro by taxol[J]. Nature,1979,277:665-667. [29] RTOG 05-21:a phase III protocol of androgen suppression and 3D CRT/IMRT vs AS and 3D CRT/IMRT followed by chemotherapy with docetaxel and prednisone for localized high risk prostate cancer.2009[DB/OL]. Accessed April 8,2010[2014-08-16]. http://rtog.org/members/protocols/0521/0521.pdf. [30] Fizazi K, Lesaunier F, Delva R, et al. Docetaxel-estramustine in high-risk localized prostate cancer: first results of the French Genitourinary Tumor Group phase III trial (GETUG12) [J].J Cli Oncol,2011,29 Suppl:abstr 4513. [31] Bolla M, Hannoun-Levi JM, Ferrero JM, et al. Concurrent and adjuvant docetaxel with three-dimensional conformal radiation therapy plus androgen deprivation for high-risk prostate cancer: preliminary results of a multicentre phase II trial[J]. Radiother Oncol,2010,l97:312-317. [32] Sanda MG, Dunn RL, Michalski J, et al. Quality of life and satisfaction with outcome among prostate-cancer survivors[J]. N Engl J Med,2008,358:1250-1261. [33] Israeli RS, Ryan CW, Jung LL. Managing bone loss in men with locally advanced prostate cancer receiving androgen deprivation therapy[J]. J Urol,2008,179:414-423. [34] D'Amico AV, Denham JW, Crook J, et al. Influence of androgen suppression therapy for prostate cancer on the frequency and timing of fatal myocardial infarctions[J]. J Clin Oncol,2007,25:2420-2425. [35] Smith MR, Lee H, McGovern F, et al. Metabolic changes during gonadotrophin-releasing hormone agonist therapy for prostate cancer. Differences from the classic metabolic syndrome[J]. Cancer,2008,112:2188-2194. [36] Efstathiou JA, Bae K, Shipley WU, et al. Cardiovascular mortality and duration of androgen deprivation for locally advanced prostate cancer: analysis of RTOG 92-02[J]. Eur Urol,2008,54:816-823. [37] Efstathiou JA, Bae K, Shipley WU, et al. Cardiovascular mortality after androgen deprivation therapy for locally advanced prostate cancer: RTOG 85-31[J]. J Clin Oncol,2009,27:92-99. [38] Grimm P, Billiet I, Bostwick D, et al. Comparative analysis of prostate-specific antigen free survival outcomes for patients with low, intermediate and high risk prostate cancer treatment by radical therapy. Results from the Prostate Cancer Results Study Group[J]. BJU Int,2012,109 Suppl 1:22-29.
2014, Vol. 23 
