New trends in prostatic cancer research. Hormone therapy in localized carcinoma of the prostate.
Seventy-five per cent of patients with carcinoma of the prostate exhibit some response to hormonal therapy. Emphasis from the very beginning to the present time has been on mechanisms of action. Studies on total androgen suppression were also developed for many years. Although the majority of the trials concerned locally advanced tumors, neo- or adjuvant hormonal therapy seems closely related to an increase in disease-free and metastasis-free survival, and local tumor control, no significant correlation was found between neo- or adjuvant radiotherapy and overall survival. Present ongoing studies are focused on patients with early cancer stage, PS > 70% and PSA < 20 ng/ml. In particular three areas are currently under investigation: dose escalation, particle therapy and radiotherapy combined with intermittent androgen suppression. Well-designed clinical trials are highly desirable to compare efficacy and specifically analyze patterns of failures with radical prostatectomy or irradiation, taking into account patient selection, staging methods, tumor characteristics, prognostic factors, etc. Endpoints should include survival, morbidity, and quality of life as well as cost-benefit of each therapeutic modality.
Perez
C A
CA
Radiation Oncology Center, Washington University Medical Center, St. Louis, MO, USA.
D000726:Androgen Antagonists / Q000627:therapeutic use*; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D006801:Humans; D008297:Male; D011471:Prostatic Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy
D000726:Androgen Antagonists