[Neoadjuvant hormonal treatment combined with external irradiation in the management of prostate cancer].
RTOG and EORTC trials have paved the way of the combination of radiation therapy and androgen suppression. Localized carcinoma with intermediate prognostic factors (cT2b, Gleason 7, or baseline PSA ranging between 10 and 20 ng/mL) may be submitted to a 4-month complete androgene blockade with 2 months before irradiation, unless to include patients in ongoing randomized trials. High risk cancers (cT2c, or Gleason > 7, or PSA > 20 ng/ml) should receive a 4-month or 6-month complete androgen blockade (RTOG trial 86-10), knowing that the results of EORTC trial 22961 are eagerly expected to tell us whether a 3- year androgen suppression is preferable. Very high risk prostate cancers, T3-4 N0 M0 or pelvic lymph node involvement (c or pN1) whatever the UICC T stage, need a long term androgen suppression of 3 years or more.
Bolla
Michel
M
Département de cancérologie-hématologie, Service d'urologie, Centre hospitalier universitaire, BP 392, 63011 Grenoble. MBolla@chu-grenoble.fr
Artignan
Xavier
X
Fourneret
Philippe
P
Brochon
Danielle
D
Ringeisen
François
F
Descotes
Jean-Luc
JL
D000726:Androgen Antagonists / Q000627:therapeutic use; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D020360:Neoadjuvant Therapy / Q000379:methods*; D009376:Neoplasms, Hormone-Dependent / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy*; D011471:Prostatic Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy*; D016032:Randomized Controlled Trials as Topic
D000726:Androgen Antagonists; D018931:Antineoplastic Agents, Hormonal