ABSTRACT

Prostate cancer is a hormone dependant disease. The use of external beam radiotherapy (EBRT) along with androgen suppression therapy (AST) increases the survival rates in high risk and locally advanced disease. In this review, the effectiveness and side effects of AST in addition to ERT will be analysed in locally advanced, high risk prostate carcinomas.

ERT is the standard treatment of choice for high risk and locally advanced stage prostate carcinomas. In this group of patients, the survival rates can be increased if AST is used in addition to RT. The combination of AST and radiotherapy is based on idea that both strategies may result in a common final pathway for tumor cell killing. When combined, the two treatment methods interact to create a more effective way of killing cancer cells. This interaction is classified as additive and supra-additive and when used together, each treatment method increases the effectiveness of the other. Either neo-adjuvant and adjuvant AST is can be used in addition to ERT. AST can be used for a short-term (<=6 months) or a long-term period (≥2 years) of time. Long-term AST improves survival in patients with locally advanced, high-risk prostate cancer that is managed with EBRT. In Long term use of AST, hot flushes, and sexual problems increased significantly but there was no significant difference in the cumulative incidence of fatal cardiac events. The side effects of RT decrease significantly when hormonal therapies are used in addition to RT.