Urologic oncology: extraordinary opportunities for discovery - New initiatives in radiation oncology

The discussion and debate over the "best" treatment for clinically localize d prostate cancer will be an iterative process based on a combination of op inions and data. Success is a measure of both cancer control and quality of life such that in a disease with a long natural history, one must be very cautious about over-interpreting short- or medium-term results. As with man y treatment approaches in the rapidly evolving world of medicine, outcomes improve over time so that retrospective studies are useful but of limited v alue due to changes in patient selection and therapeutic technique. Overly aggressive multimodality approaches will produce excellent short-term resul ts such as PSA biochemical NED (bNED), yet these may be more costly in term s of toxicity and expense than necessary compared to uni-modality therapy. (C) 2001 Elsevier Science Inc. All rights reserved.