THE CURRENT STATUS OF ADJUVANT HORMONAL-THERAPY COMBINED WITH RADIATION-THERAPY FOR LOCALIZED PROSTATE-CANCER

Analysis of the results of treatment of localised prostate cancer with radiation and surgery has identified patients who are at high risk of developing metastatic dissemination. High histologic grade, serum pro state specific antigen above 20 ng/ml, extension beyond the capsule of the prostate, and involvement of lymph nodes are highly predictive of metastatic risk, Antiandrogen therapy has high rates of activity in t he treatment of overt metastatic disease prompting its assessment as a n adjuvant treatment added to radiation therapy. There are now major p rospective randomized trials which have been completed. The current ev idence indicates that a large survival benefit ensues when antiandroge n therapy is added to radiation for appropriately selected patients. T his adjuvant approach is likely to become the standard of care. Strate gies for further enhancement of adjuvant therapy are discussed.