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Hormonal Therapy and Radiation Therapy: Randomized and Prospective Trials

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Radiotherapy in Prostate Cancer

Part of the book series: Medical Radiology ((Med Radiol Radiat Oncol))

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Abstract

In high risk prostate cancer (PCa), the aim of androgen deprivation therapy (ADT) is to improve the therapeutic ratio of radiotherapy (RT) by potentiating irradiation whatever its technique and destroying the infraclinical disease located outside the irradiated volume. Many phase III randomized trials have paved the way for establishing the indications of the combination of ADT with external irradiation. For locally advanced PCa, long-term ADT (≥2 years) with LHRH agonists combined with external irradiation is a gold standard (level 1a of evidence); should there be a significant comorbidity, a reticence of the patients who want to remain potent or a poor tolerance, a 6-month duration may be proposed unless to choose an anti-androgen monotherapy. For high risk localized PCa 4–6-months complete ADT is recommended (level 2a evidence). For intermediate risk localized PCa, patients may benefit from a combined approach with a short-term ADT. IMRT has replaced conventional irradiation and allows a dose escalation recommended for high risk PCa, offering also the opportunity to treat intermediate risk localized PCa without ADT. Patients have to be informed of the potential morbidity of ADT and a close cooperation is needed with general practitioners and specialists to prevent or minimize harmful side effects as much as possible and to maintain quality of life.

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Authors and Affiliations

  1. Clinique Universitaire de Cancérologie-Radiothérapie, Centre Hospitalier Universitaire Albert Michallon, BP 217 38043 cedex 9, Grenoble, France

    Michel Bolla, Camille Verry, Violaine Brun Baronnat & Alexandre Tessier

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  1. Michel Bolla
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  2. Camille Verry
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  3. Violaine Brun Baronnat
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  4. Alexandre Tessier
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Correspondence to Michel Bolla .

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Editors and Affiliations

  1. Department of Radiation Oncology, Krankenhaus der Barmherzigen, Schwestern Linz, Johannes Kepler University, Linz, Austria

    Hans Geinitz

  2. University of California, San Francisco Department of Radiation Oncology, San Francisco, California, USA

    Mack Roach III

  3. The Institute of Cancer Research Sutton, Sutton Surrey, United Kingdom

    Nicholas van As

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Bolla, M., Verry, C., Brun Baronnat, V., Tessier, A. (2014). Hormonal Therapy and Radiation Therapy: Randomized and Prospective Trials. In: Geinitz, H., Roach III, M., van As, N. (eds) Radiotherapy in Prostate Cancer. Medical Radiology(). Springer, Berlin, Heidelberg. https://doi.org/10.1007/174_2014_999

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