What is the role of combined radiotherapy and androgen ablation for the treatment of prostate cancer?

Updated: Nov 29, 2018
  • Author: Isamettin Andrew Aral, MD, MS; Chief Editor: Edward David Kim, MD, FACS  more...
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Answer

Answer

The primary purpose of combining hormonal blockade with radiotherapy continues to evolve. Initial attempts at combined treatment approaches centered on the obvious results of hormonal blockade (ie, prostate downsizing). The results of several phase III clinical trials suggest that the true benefit of combining radiotherapy with androgen blockade may lie in the potentially synergistic effects of the 2 treatments.

Data from the Radiation Therapy Oncology Group (RTOG) have shown a clear improvement in biochemical control of disease when patients are treated with a combination of radiotherapy and androgen-suppressive therapy. Initial data suggest that patients with a Gleason score of 7 or higher may have an improved survival rate.

The mechanism by which hormonal blockade enhances the effects of radiotherapy is unclear; however, induction of apoptosis may be an important component of its action. Others have proposed that shifting of the cell cycle (ie, to a more sensitive component of the cycle) may underlie the benefit of combined therapy.


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