Hormone treatment combined with radiotherapy

Oncology 12

Hormones + Radiotherapy – Locally Advanced Prostate Cancer – T3/T4

Traditionally, single modality treatment for locally advanced and high risk prostate cancer patients results in high failure rate

Hormones + Radiotherapy – Locally Advanced Prostate Cancer – T3/T4

Hormones + Radiotherapy – Locally Advanced Prostate Cancer – T3/T4

Short Term Neoadjuvant + Radiotherapy RTOG 86-10

Roach, M. et al. J Clin Oncol; 26:585-591 2008

Overall survival

Short Term Neoadjuvant + Radiotherapy RTOG 86-10

Roach, M. et al. J Clin Oncol; 26:585-591 2008

Overall survival

Hormones + Radiotherapy – Locally Advanced Prostate Cancer – T3/T4

Adjuvant + Radiotherapy RTOG 85-31

Pilepich et al. Int J Rad Oncol Biol Phys 2005; 61:1285

Overall survival

Adjuvant + Radiotherapy RTOG 85-31

Pilepich et al. Int J Rad Oncol Biol Phys 2005; 61:1285

Overall survival

Hormones + Radiotherapy – Locally Advanced Prostate Cancer – T3/T4

Concurrent + Adjuvant + Radiotherapy EORTC 22863

Bolla M et al. Int J Rad Oncol Bio Phys 2008;72 Bolla M et al. Lancet 2010

Concurrent + Adjuvant + Radiotherapy EORTC 22863

Bolla M et al. Int J Rad Oncol Bio Phys 2008;72 Bolla M et al. Lancet 2010

Hormones + Radiotherapy – Locally Advanced Prostate Cancer – T3/T4

Neoadjuvant + Adjuvant + Radiotherapy RTOG 92-02

Hanks GE et al. J Clin Oncol 2008; 21:3972

Overall survival

Disease Free Survival

Hormones + Radiotherapy – Locally Advanced Prostate Cancer – T3/T4

What Should be the Duration of Hormone Therapy?

Hormones + Radiotherapy – Locally Advanced Prostate Cancer – T3/T4

Duration of Hormone Treatment

Overall Survival

Cardiac Event Mortality

Bolla M et al. NEJM 2009;360:2516

Duration of Hormone Treatment

Bolla M et al. NEJM 2009;360:2516

Quality of Life

Sexual ActivityDecreased Libido

Insomnia Hot Flashes

EAU Guidelines 2014

• minimum dose of > 74 Gy is recommended for EBRT + hormone therapy