Radiotherapy and Hormone Therapy in Intermediate Risk Prostate Cancer: a Critical Review

Detalhes bibliográficos
Autor(a) principal: Franco, Rejane Carolina
Data de Publicação: 2015
Outros Autores: Souhami, Luis
Tipo de documento: Artigo
Idioma: por
Título da fonte: Revista Brasileira de Cancerologia (Online)
DOI: 10.32635/2176-9745.RBC.2015v61n2.754
Texto Completo: https://rbc.inca.gov.br/index.php/revista/article/view/754
Resumo: Introduction: The standard treatment for patients with high risk prostate cancer is the combined use of radiation therapy (RT) and hormone therapy (HT). In regards to patients stratified as intermediate risk, the use of HT associated with RT remains controversial, and its use should be carefully planned and based on available evidence. Objective: To critically assess results of randomized studies published in the literature that associated the use of HT of short duration with an average period of 6 months with RT in the treatment of patients with localized prostate cancer classified as intermediate risk. Method: Only randomized studies comparing these treatments were eligible for this review. A structured search through “PubMed” was carried out using the terms “androgen suppression therapy”, “radiotherapy”, “randomized trials”, “phase 3 trials”, “prostate cancer” and “intermediate risk”. Results: Four randomized studies comparing RT alone to RT plus short course HT were found and selected. The majority of the trials had a mixed population of intermediate and high risk disease and did not include patients with only intermediate risk. Despite that, there appears to be a significant benefit for the combined approach regarding disease-free survival, biochemicalfree survival and overall survival. Conclusion: The randomized studies published so far suggest improved outcomes for the group of patients receiving RT and short course HT. Data from randomized trials comparing RT alone to RT and short course HT in patients with intermediate risk only are forthcoming.
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spelling Radiotherapy and Hormone Therapy in Intermediate Risk Prostate Cancer: a Critical ReviewRadioterapia y Terapia Hormonal en el Cáncer de Próstata de Riesgo Intermedio: una Revisión CríticaRadioterapia e Hormonioterapia no Câncer de Próstata de Risco Intermediário: uma Revisão CríticaNeoplasias da Próstata/terapiaRadioterapiaHormônios/uso terapêuticoTerapia CombinadaRevisãoProstatic Neoplasms/therapyRadiotherapyHormones/therapeutic useCombined Modality TherapyReviewNeoplasias de la Próstata/terapiaRadioterapiaHormonas/uso terapéuticoTerapia CombinadaRevisiónIntroduction: The standard treatment for patients with high risk prostate cancer is the combined use of radiation therapy (RT) and hormone therapy (HT). In regards to patients stratified as intermediate risk, the use of HT associated with RT remains controversial, and its use should be carefully planned and based on available evidence. Objective: To critically assess results of randomized studies published in the literature that associated the use of HT of short duration with an average period of 6 months with RT in the treatment of patients with localized prostate cancer classified as intermediate risk. Method: Only randomized studies comparing these treatments were eligible for this review. A structured search through “PubMed” was carried out using the terms “androgen suppression therapy”, “radiotherapy”, “randomized trials”, “phase 3 trials”, “prostate cancer” and “intermediate risk”. Results: Four randomized studies comparing RT alone to RT plus short course HT were found and selected. The majority of the trials had a mixed population of intermediate and high risk disease and did not include patients with only intermediate risk. Despite that, there appears to be a significant benefit for the combined approach regarding disease-free survival, biochemicalfree survival and overall survival. Conclusion: The randomized studies published so far suggest improved outcomes for the group of patients receiving RT and short course HT. Data from randomized trials comparing RT alone to RT and short course HT in patients with intermediate risk only are forthcoming.Introducción: El tratamiento estandar de la neoplasia próstata es de alto riesgo tiene el uso combinado de la radioterapia (RT) y terapia hormonal (HT). En cuanto a los pacientes estratificados como de riesgo intermedio, el tratamiento hormonal combinado con la RT sigue siendo controvercial y debe tener indicaciones prudentes y basadas en la evidencia disponible. Objetivo: Evaluar críticamente los resultados publicados en la literatura con el uso de hormonas por corto tiempo en un periodo medio de seis meses asociado a RT en el tratamiento de pacientes con neoplasia de próstata localizada y clasificada como de riesgo intermedio. Método: Revisión de literatura con estudios randomizados en RT y HT para pacientes con riesgo intermedio de cáncer de próstata se encontraron y se consideraron. Una búsqueda estructurada a través de "PubMed" con los términos "terapia de supresión androgénica", "radioterapia", "ensayos aleatorios", "ensayo de fase 3", "cáncer de próstata" y "riesgo intermedio" Resultados: Cuatro estudios randomizados comparando RT versus RT y HT a corto plazo duracion fueron considerados. La mayoría de los estudios mezcla pacientes con riesgo intermedio y alto y no los separa exclusivamente por la estratificación de riesgo intermedio. Los datos, sin embargo, sugieren un beneficio significativo de la supervivencia libre de la enfermedad, supervivencia libre de progresión bioquímica y supervivencia global para el uso del tratamiento combinado. Conclusión: Los estudios publicados hasta la fecha mostraron una tendencia a mejores resultados para el grupo de tratamiento combinado. Se están realizando estudios aleatorios que comparan RT aislada versus RT asociada con la HT a corto plazo solo los pacientes con riesgo intermedio.Introdução: O tratamento padrão da neoplasia prostática de alto risco e o uso combinado de radioterapia (RT) e hormonioterapia (HT). Em relação aos pacientes estratificados como risco intermediário, o tratamento hormonal associado a RT permanece controverso, devendo ter indicação criteriosa e baseada em evidencias disponíveis. Objetivo: Avaliar criticamente os resultados publicados na literatura com o uso de hormônio por curto tempo, período médio de seis meses, associado a RT no tratamento de pacientes com neoplasia prostática localizada e classificada como risco intermediário. Método: Revisão de literatura com estudos randomizados utilizando RT e HT para pacientes com câncer de próstata de risco intermediário foram encontrados e considerados. Busca estruturada por meio do ‘PubMed’ com os termos ‘androgen supression therapy’, ‘radiotherapy’, ‘randomized trials’, ‘phase 3 trial’, ‘prostate cancer’ e ‘intermediate risk’. Resultados: Quatro estudos randomizados comparando RT versus RT e HT de curta duração foram considerados. A maioria agrupa pacientes com riscos intermediário e alto e não os separa exclusivamente pela estratificação do risco intermediário. Os dados encontrados, no entanto, sugerem beneficio significativo de sobrevida livre de doença, sobrevida livre de falha bioquímica e sobrevida global para o uso do tratamento combinado. Conclusão: Por meio dos estudos publicados ate o momento, observaram-se melhores resultados para o grupo de tratamento combinado de RT com HT. Dados de estudos randomizados comparando RT isolada versus RT e HT de curta duração avaliando apenas pacientes com risco intermediário estão sendo realizados.INCA2015-06-30info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionRevisão de literaturaapplication/pdfhttps://rbc.inca.gov.br/index.php/revista/article/view/75410.32635/2176-9745.RBC.2015v61n2.754Revista Brasileira de Cancerologia; Vol. 61 No. 2 (2015): Apr./May/June; 155-163Revista Brasileira de Cancerologia; Vol. 61 Núm. 2 (2015): abr./mayo/jun.; 155-163Revista Brasileira de Cancerologia; v. 61 n. 2 (2015): abr./maio/jun.; 155-1632176-9745reponame:Revista Brasileira de Cancerologia (Online)instname:Instituto Nacional de Câncer José Alencar Gomes da Silva (INCA)instacron:INCAporhttps://rbc.inca.gov.br/index.php/revista/article/view/754/484Franco, Rejane CarolinaSouhami, Luisinfo:eu-repo/semantics/openAccess2021-11-29T20:08:45Zoai:rbc.inca.gov.br:article/754Revistahttps://rbc.inca.gov.br/index.php/revistaPUBhttps://rbc.inca.gov.br/index.php/revista/oairbc@inca.gov.br0034-71162176-9745opendoar:2021-11-29T20:08:45Revista Brasileira de Cancerologia (Online) - Instituto Nacional de Câncer José Alencar Gomes da Silva (INCA)false
dc.title.none.fl_str_mv Radiotherapy and Hormone Therapy in Intermediate Risk Prostate Cancer: a Critical Review
Radioterapia y Terapia Hormonal en el Cáncer de Próstata de Riesgo Intermedio: una Revisión Crítica
Radioterapia e Hormonioterapia no Câncer de Próstata de Risco Intermediário: uma Revisão Crítica
title Radiotherapy and Hormone Therapy in Intermediate Risk Prostate Cancer: a Critical Review
spellingShingle Radiotherapy and Hormone Therapy in Intermediate Risk Prostate Cancer: a Critical Review
Radiotherapy and Hormone Therapy in Intermediate Risk Prostate Cancer: a Critical Review
Franco, Rejane Carolina
Neoplasias da Próstata/terapia
Radioterapia
Hormônios/uso terapêutico
Terapia Combinada
Revisão
Prostatic Neoplasms/therapy
Radiotherapy
Hormones/therapeutic use
Combined Modality Therapy
Review
Neoplasias de la Próstata/terapia
Radioterapia
Hormonas/uso terapéutico
Terapia Combinada
Revisión
Franco, Rejane Carolina
Neoplasias da Próstata/terapia
Radioterapia
Hormônios/uso terapêutico
Terapia Combinada
Revisão
Prostatic Neoplasms/therapy
Radiotherapy
Hormones/therapeutic use
Combined Modality Therapy
Review
Neoplasias de la Próstata/terapia
Radioterapia
Hormonas/uso terapéutico
Terapia Combinada
Revisión
title_short Radiotherapy and Hormone Therapy in Intermediate Risk Prostate Cancer: a Critical Review
title_full Radiotherapy and Hormone Therapy in Intermediate Risk Prostate Cancer: a Critical Review
title_fullStr Radiotherapy and Hormone Therapy in Intermediate Risk Prostate Cancer: a Critical Review
Radiotherapy and Hormone Therapy in Intermediate Risk Prostate Cancer: a Critical Review
title_full_unstemmed Radiotherapy and Hormone Therapy in Intermediate Risk Prostate Cancer: a Critical Review
Radiotherapy and Hormone Therapy in Intermediate Risk Prostate Cancer: a Critical Review
title_sort Radiotherapy and Hormone Therapy in Intermediate Risk Prostate Cancer: a Critical Review
author Franco, Rejane Carolina
author_facet Franco, Rejane Carolina
Franco, Rejane Carolina
Souhami, Luis
Souhami, Luis
author_role author
author2 Souhami, Luis
author2_role author
dc.contributor.author.fl_str_mv Franco, Rejane Carolina
Souhami, Luis
dc.subject.por.fl_str_mv Neoplasias da Próstata/terapia
Radioterapia
Hormônios/uso terapêutico
Terapia Combinada
Revisão
Prostatic Neoplasms/therapy
Radiotherapy
Hormones/therapeutic use
Combined Modality Therapy
Review
Neoplasias de la Próstata/terapia
Radioterapia
Hormonas/uso terapéutico
Terapia Combinada
Revisión
topic Neoplasias da Próstata/terapia
Radioterapia
Hormônios/uso terapêutico
Terapia Combinada
Revisão
Prostatic Neoplasms/therapy
Radiotherapy
Hormones/therapeutic use
Combined Modality Therapy
Review
Neoplasias de la Próstata/terapia
Radioterapia
Hormonas/uso terapéutico
Terapia Combinada
Revisión
description Introduction: The standard treatment for patients with high risk prostate cancer is the combined use of radiation therapy (RT) and hormone therapy (HT). In regards to patients stratified as intermediate risk, the use of HT associated with RT remains controversial, and its use should be carefully planned and based on available evidence. Objective: To critically assess results of randomized studies published in the literature that associated the use of HT of short duration with an average period of 6 months with RT in the treatment of patients with localized prostate cancer classified as intermediate risk. Method: Only randomized studies comparing these treatments were eligible for this review. A structured search through “PubMed” was carried out using the terms “androgen suppression therapy”, “radiotherapy”, “randomized trials”, “phase 3 trials”, “prostate cancer” and “intermediate risk”. Results: Four randomized studies comparing RT alone to RT plus short course HT were found and selected. The majority of the trials had a mixed population of intermediate and high risk disease and did not include patients with only intermediate risk. Despite that, there appears to be a significant benefit for the combined approach regarding disease-free survival, biochemicalfree survival and overall survival. Conclusion: The randomized studies published so far suggest improved outcomes for the group of patients receiving RT and short course HT. Data from randomized trials comparing RT alone to RT and short course HT in patients with intermediate risk only are forthcoming.
publishDate 2015
dc.date.none.fl_str_mv 2015-06-30
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
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dc.identifier.uri.fl_str_mv https://rbc.inca.gov.br/index.php/revista/article/view/754
10.32635/2176-9745.RBC.2015v61n2.754
url https://rbc.inca.gov.br/index.php/revista/article/view/754
identifier_str_mv 10.32635/2176-9745.RBC.2015v61n2.754
dc.language.iso.fl_str_mv por
language por
dc.relation.none.fl_str_mv https://rbc.inca.gov.br/index.php/revista/article/view/754/484
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv INCA
publisher.none.fl_str_mv INCA
dc.source.none.fl_str_mv Revista Brasileira de Cancerologia; Vol. 61 No. 2 (2015): Apr./May/June; 155-163
Revista Brasileira de Cancerologia; Vol. 61 Núm. 2 (2015): abr./mayo/jun.; 155-163
Revista Brasileira de Cancerologia; v. 61 n. 2 (2015): abr./maio/jun.; 155-163
2176-9745
reponame:Revista Brasileira de Cancerologia (Online)
instname:Instituto Nacional de Câncer José Alencar Gomes da Silva (INCA)
instacron:INCA
instname_str Instituto Nacional de Câncer José Alencar Gomes da Silva (INCA)
instacron_str INCA
institution INCA
reponame_str Revista Brasileira de Cancerologia (Online)
collection Revista Brasileira de Cancerologia (Online)
repository.name.fl_str_mv Revista Brasileira de Cancerologia (Online) - Instituto Nacional de Câncer José Alencar Gomes da Silva (INCA)
repository.mail.fl_str_mv rbc@inca.gov.br
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dc.identifier.doi.none.fl_str_mv 10.32635/2176-9745.RBC.2015v61n2.754