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Androgen Deprivation Therapy and Definitive Radiotherapy for Prostate Cancer

Mendenhall, William M. MD*,†; Henderson, Randal H. MD, MBA; Hoppe, Bradford S. MD, MPH; Nichols, Romaine Charles MD; Mendenhall, Nancy P. MD

American Journal of Clinical Oncology: October 2013 - Volume 36 - Issue 5 - p 530–534
doi: 10.1097/COC.0b013e31821dee4e
Review Articles

Adjuvant androgen deprivation therapy (ADT) improves outcomes of patients receiving definitive radiotherapy (RT) for local-regionally advanced prostate cancer. However, patients in most randomized trials had more advanced disease than observed in many practices and were treated with suboptimal RT doses. Although data are conflicting, long-term ADT likely has adverse side-effects in patients with comorbidities. We recommend 6 months of ADT monotherapy with gonadotropin-releasing hormone agonist and RT for patients with high-risk prostate cancer (≥T2c, Gleason Score 8 to 10, and/or prostate-specific antigen ≥20 ng/mL) with minimal or no comorbidities. Adjuvant ADT for unfavorable intermediate-risk patients with a Gleason Score of 4+3=7 is also reasonable.

*Department of Radiation Oncology at the University of Florida College of Medicine, Gainesville

University of Florida Proton Therapy Institute, Jacksonville, FL

Reprints: William M. Mendenhall, MD, 2000 South-West Archer Road, PO Box 100385, Gainesville, FL 32610-0385. e-mail: mendwm@shands.ufl.edu.

The authors declare no conflicts of interest.

© 2013 by Lippincott Williams & Wilkins, Inc