Department of Radiation Oncology at the University of Florida College of Medicine, Gainesville, FL.University of Florida Proton Therapy Institute, Jacksonville, FL.
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.
Mendenhall WM, Henderson RH, Hoppe BS, Nichols RC, Mendenhall NP. Are you the author?
Reference: Am J Clin Oncol. 2011 Jun 18. Epub ahead of print.