The Indication of Antiandrogen Therapy and Timing of Radiotherapy in Case of Prostate Cancer Relapse: a Literature Discussion on Shipley et al. 2017

Abstract

Roth, Stephan Ludwig

The authors Shipley et al. (1917) report on the results of a phase-3 RTOG-Study, which demonstrates, that a 24-months anti androgen therapy with daily bicalutamide in addition to salvage radiotherapy prolongs in high risk patients (high PSA-values, i.e. >0, 7 ng/ml) the long-term survival and reduces the rate of metastases. However the RTOG-study does not report on relevant other urogenital, hepatotoxic or cardiac side effects. An evaluation of the data of the Martini-clinic in Hamburg yielded that a radical prostatectomy leads in 9% to an incontinence (>1 pads/24 hours), in 13% in case of a postoperative radiotherapy. After surgery alone the potency was maintained in 58% compared to only 40% (p=0,001) after trimodal therapy. The question is to debate, if the indication for an immediate postoperative radiotherapy should be chosen or, still better, a primary radiotherapy should be preferred in patients with median or high risk.

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