Conventional external-beam radiation therapy alone or with androgen ablation for clinical stage III (T3, NX/N0, M0) adenocarcinoma of the prostate

Non‐invasive evaluation of tumour hypoxia in the Shionogi tumour model for prostate cancer with 18F‐EF5 and positron emission tomography

“…In prostate cancer, oxygen levels measured using pO 2 electrodes show that levels of hypoxia increase with clinical stage [10], and that the prostate/muscle hypoxia predicts biochemical failure after radiotherapy [7]. Results from clinical trials evaluating combined ADT and radiotherapy imply that the duration and/or timing of androgen ablation with respect to radiation might also be important [11][12][13][14]. However, at present it remains unclear if hypoxia is a factor in these studies, as the trials were not designed to examine hypoxic levels in the tumours.…”

“…These reports suggest that tumour hypoxia is an additional factor that should be considered in the management of prostate cancer, particularly as radiotherapy is a common treatment, used alone or in combination with androgen-deprivation therapy (ADT) [11][12][13][14].…”

“…Furthermore, there might be synergistic interaction between hormonal therapy and radiation, as ADT is known to enhance tumour cell death through apoptosis [15]; thus ADT applied before the delivery of radiation substantially decreases the radiation dose required to control half of transplanted Shionogi tumours, compared to the dose required when the ADT is instituted after radiation [16]. In the clinic, recurrence rates are unacceptably high with radiation monotherapy, but several clinical studies have shown improved therapeutic benefits when radiation is combined with hormone therapy [11][12][13]. Indeed, combined hormone and radiation treatment is now considered standard therapy for managing patients with high-risk prostate cancer.…”

Adjuvant androgen deprivation impacts late rectal toxicity after conformal radiotherapy of prostate carcinoma

“…While some quoted studies did not even mention late toxicity (Pollack et al, 1995;Zagars et al, 1999;Laverdiere et al, 1997), some other reports may suggest a reduced tolerance of both genitourinary and gastrointestinal systems in presence of AAD (Bolla et al, 1997;Fiorino et al, 2001;Sanguineti et al, 2000).…”

The prognostic impact of cytokeratin‐positive cells in bone marrow of patients with localized prostate cancer

“…12,19 -21 In most studies on localized prostate cancer today, biochemical failure represents the outcome parameter either alone or often in combination with clinical progression. 28,29 However, as shown by Kupelian et al, rising PSA after curatively intended local treatment in general predicts the development of clinical progression, often after long intervals. 30 Pound et al reported that PSA progression preceded the diagnosis of distant metastases by a median time of 8 years after radical prostatectomy.…”