Combination of Androgen Deprivation Therapy and Radiation Therapy for Locally Advanced and Localized Prostate Cancer

  • Michel Bolla
  • Camille Verry


In high-risk prostate cancer (PCa), the aim of androgen deprivation therapy (ADT) is to improve the therapeutic ratio of 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≥or =(≥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 antiandrogen monotherapy. For high-risk localized PCa 4–6-month 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 as much as possible harmful side effects to maintain quality of life.


Gleason Score Androgen Deprivation Therapy Radiation Therapy Oncology Group LHRH Agonist Radiation Therapy Oncology Group Trial 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



Androgen deprivation therapy


Clinical target volume


Combined androgen deprivation therapy


Dose volume histogram


European Organization on Treatment and Research of Cancer


Genitourinary tumor group


Hormone therapy


Intensity-modulated radiotherapy


Long-term androgen deprivation therapy


Luteinizing-hormone-releasing hormone


Medical Research Council


Memorial Sloan-Kettering Cancer Center


National Cancer Institute Canada


Neoadjuvant concurrent androgen deprivation therapy


Progression-free survival


Prostate cancer


Prostate only radiotherapy


Prostate-specific antigen


Radiation therapy oncology group




Short-term androgen deprivation therapy

TCD 50

Dose which controls 50% of tumors


Three-dimensional conformal ­radiotherapy


Whole-pelvis radiotherapy


World Health Organization


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Suggested Readings

  1. (2000) Maximum androgen blockade in advanced prostate cancer: an overview of the randomised trials. Prostate Cancer Trialists’ Collaborative Group. Lancet 355:1491–1498Google Scholar
  2. (2009) RTOG 05–21:A phase III protocol of androgen suppression (AS) and 3D CRT/IMRT vs AS and 3D CRT/IMRT followed by chemotherapy with docetaxel and prednisone for localized high risk prostate cancer. [PDF]. Accessed 8 Apr 2010

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© Springer-Verlag Berlin Heidelberg 2012

Authors and Affiliations

  1. 1.Clinique Universitaire de Cancérologie-Radiothérapie, Centre Hospitalier Universitaire Albert MichallonCedex 9 GrenobleFrance

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