IDENTIFICATION OF INTERMEDIATE-RISK PROSTATE-CANCER PATIENTS TREATED WITH RADICAL RADIOTHERAPY SUITABLE FOR NEOADJUVANT HORMONE STUDIES

We undertook a retrospective review of patients presenting with appare ntly localised prostatic carcinoma to a single practitioner for consid eration of radiation therapy to clarify the characteristics of those p atients who might benefit from the use of neo-adjuvant androgen depriv ation. OF 133 patients referred between January 1989 and June 1994, 85 were considered suitable for radical therapy, of whom 31 were treated with hormone therapy prior to radiotherapy, frequently on the basis o f an elevated PSA. Increasing PSA levels (p = 0.0016) and Gleason grad e (p = 0.026) were independent variables for relapse. It uas possible to define three prognostic groups of patients, on the basis oi initial PSA and Gleason grade. Those of intermediate risk (PSA < 10 mu g/l, G leason score 8-10; PSA 10-25 mu g/l, Gleason 5-7 or 8-10; PSA > 25 mu g/l, Gleason score 2-4) had a superior duration of disease-free surviv al ii given initial hormone therapy. This group of patients is potenti ally the most likely to benefit from such an approach and should be en rolled in prospective randomised studies of neoadjuvant androgen depri vation.