[Oncology forum in urology].
OBJECTIVE
To present to the radiation oncologist the main advances in prostate cancer in the last year


METHODS
A review of the main congress in uro-oncology (ASCO, ASTRO, AUA, EAU) and international literature


RESULTS
The increase in the incidence of prostate cancer without increasing in mortality must be a signal for oncologist to propose active surveillance to the patients without bad prognostic factors. Use of biomarkers could probably facilitate the selection of patients needing treatment. After prostatectomy, adjuvant radiotherapy could decrease the biochemical relapse rate but also the risk of distant metastasis, particularly for pT3 R1 patients; but the optimal time to deliver this post-operative radiotherapy is discussed: immediately after surgery or delayed in case of PSA relapse (> or = 0,2 ng/ml). For locally advanced disease, combination of radiotherapy and long-term androgen deprivation improved survival over hormonal treatment alone. But duration of androgen deprivation must be adapted to the comorbidities of the patient because of the risk of metabolic syndrome. The value of dose escalation in association with hormonal treatment must be defined.


CONCLUSIONS
Important advances in prostate cancer management have been made during the last months, but inclusion of patients into on-going prospective studies is still important to continue to improve the therapeutic results.
Richaud
Pierre
P
Département de Radiothérapie, Institut Bergonié, Bordeaux.
Hennequin
Christophe
C
D000726:Androgen Antagonists / Q000009:adverse effects / Q000627:therapeutic use; D014408:Biomarkers, Tumor / Q000378:metabolism; D017024:Chemotherapy, Adjuvant; D015897:Comorbidity; D005602:France / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D024821:Metabolic Syndrome / Q000139:chemically induced / Q000517:prevention & control; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control; D018579:Patient Selection; D011182:Postoperative Care / Q000379:methods; D011379:Prognosis; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000532:radiotherapy*; D018787:Radiation Oncology / Q000379:methods* / Q000639:trends; D011879:Radiotherapy Dosage; D018714:Radiotherapy, Adjuvant; D015996:Survival Rate; D016896:Treatment Outcome
D000726:Androgen Antagonists; D014408:Biomarkers, Tumor