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KMID : 1001020140120030106
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Korean Journal of Urological Oncology
2014 Volume.12 No. 3 p.106 ~ p.111
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What’s New in Radiation Therapy for High Risk Prostate Cancer
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Kim Soo-Dong
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Abstract
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Several studies have shown the efficacy of endocrine therapy in combination with radiotherapy in high-risk prostate cancer. In patients with locally advanced or high-risk prostate cancer, addition of local radiotherapy to endocrine treatment halved the 10-year prostate-cancer-specific mortality and substantially decreased overall mortality with fully acceptable risk of side-effects compared with endocrine treatment alone. Nowadays, there are two main topics in radiation therapy for high risk prostate cancer. One is radiation dose escalation and the other is hypofractionation. First, high radiation dose levels were associated with improved biochemical tumor control and decreased risk of distant metastasis. For high risk patients, despite the delivery of high radiation dose levels, the use of ADT conferred an additional benefit for improved tumor control outcomes. Second, the moderate or extreme hypofractionation radiation therapy in prostate cancer appear favorable, but the quality of the data is still limited. Biochemical control toxicity profiles seem acceptable, but small sample sizes preclude precise estimates of efficacy and toxicity, and short follow-up times cannot rule out complications beyond 3-5years. We have to wait the result of randomized several trials that are ongoing.
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KEYWORD
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Dose escalation, Hypofractionation, Prostate cancer
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