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Radiotherapy for high-risk prostate cancer

Nature Reviews Urology volume 12, pages 145–154 (2015)Cite this article

Subjects

Key Points

  • Radiation therapy for high-risk prostate cancer provides an overall survival benefit compared with conservative management with androgen deprivation therapy (ADT) alone

  • The addition of long-term (2–3 years) ADT to radiation therapy for high-risk prostate cancer provides an overall survival benefit

  • Dose-escalated radiation therapy improves cancer control compared with conventional radiation doses

  • Ongoing research is evaluating hypofractionation, whole-pelvic radiotherapy, and combinations of newer hormonal agents with radiation as potential ways to further improve patient outcomes in high-risk prostate cancer

Abstract

The combination of radiation treatment and long-term androgen deprivation therapy (ADT) has been shown in multiple clinical trials to prolong overall survival in men with high-risk prostate cancer compared with either treatment alone. New radiation technologies enable the safe delivery of high radiation doses that improve cancer control compared with lower radiation doses. Based on the results of multiple randomized trials, clinical practice guidelines for high-risk prostate cancer recommend total radiation doses of at least 75.6 Gy, with long-term (2–3 years) ADT. Ongoing research into hypofractionated radiation treatment, whole-pelvic radiation, and combinations of radiation with novel hormonal agents could further improve cancer control and survival outcomes for patients with high-risk prostate cancer.

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  1. Department of Radiation Oncology, University of North Carolina at Chapel Hill, Chapel Hill, 27599, NC, USA

    Jahan J. Mohiuddin, Brock R. Baker & Ronald C. Chen

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Mohiuddin, J., Baker, B. & Chen, R. Radiotherapy for high-risk prostate cancer. Nat Rev Urol 12, 145–154 (2015). https://doi.org/10.1038/nrurol.2015.25

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