title: The role of androgen deprivation therapy plus radiation therapy in patients with non-metastatic prostate cancer.
abstract: BACKGROUND
  Androgen deprivation therapy (ADT) has a long and illustrious history in the treatment for prostate cancer and continues to be a mainstay treatment for locally advanced and high-risk patients. Because the survival for even high-risk prostate patients is lengthy, details of treatment such as duration and timing must be considered carefully and weighed against the various side effects.
  
  
  METHODS
  In the following article, we discuss the evolution of ADT from its initial applications in metastatic prostate cancer to its more recent incorporation into front line treatment in conjunction with radiation therapy (RT) for intermediate and high risk disease. We emphasize the results of phase III trials, which have defined the role of ADT in combination with RT in this patient population. We emphasize not only the potential benefits of ADT with RT, but also the potential risks, and underscore the need to consider both in order to maximize the therapeutic ration for each patient. Studies were identified via a search of PubMed as well as the bibliographies of articles discussed herein. Expert commentary: Even with advanced radiation techniques and dose escalation, adjuvant ADT continues to confer an overall survival benefit in intermediate and high-risk patients, although some evidence suggest that duration of treatment may be shortened, particularly for the high-risk group. The coming years will shed further information on this complicated topic with maturing of results from several ongoing trials.
authors.affiliation: a Department of Radiation Oncology , Virginia Commonwealth University , Richmond , VA , USA.
authors.forename: Sherry
authors.initials: S
authors.lastname: Zhao
authors.affiliation: a Department of Radiation Oncology , Virginia Commonwealth University , Richmond , VA , USA.
authors.forename: Alfredo I
authors.initials: AI
authors.lastname: Urdaneta
authors.affiliation: a Department of Radiation Oncology , Virginia Commonwealth University , Richmond , VA , USA.
authors.forename: Mitchell S
authors.initials: MS
authors.lastname: Anscher
mesh_terms: D000726:Androgen Antagonists / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D018931:Antineoplastic Agents, Hormonal / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D017024:Chemotherapy, Adjuvant / Q000379:methods; D003131:Combined Modality Therapy; D004305:Dose-Response Relationship, Drug; D006801:Humans; D008297:Male; D011471:Prostatic Neoplasms / Q000473:pathology / Q000628:therapy*; D015996:Survival Rate; D013997:Time Factors
chemical_list: D000726:Androgen Antagonists; D018931:Antineoplastic Agents, Hormonal
keywords: Prostate cancer; androgen deprivation therapy; bicalutamide; duration; hormone therapy; intermittent; leuprolide; radiation therapy; side effects