RADIOTHERAPY OF LOCALIZED CANCER OF THE P ROSTATE - CURRENT STATUS AND NEW STRATEGIES

Radiation therapy is a well established modality for the management of prostate cancer and the reported results are comparable to those obta ined with radical prostatectomy. After the introduction of prostate sp ecific antigen (PSA) determination, when results are analyzed on the b asis of strict biochemical criteria, it is clearly evident that total and permanent eradication of the localized prostate cancer is obtained less frequently than what was thought in the las few decades. Althoug h there are currently only a few series with radical radiation therapy with long results and with complete PSA determination during follow-u p, disease free survival (DFS) for T1b-T2 Nx is approximately 65% at 4 -5 years, whereas for T1-2 NO DFS at 9-10 years is maintained between 67% and 83%. New therapeutic strategies leading to improvement in the locoregional control are discussed, including dose escalation programs in the setting of new technologies of three-dimensional conforma radi ation therapy, and neoadjuvant androgenic blockade.