Combined Modality Therapies for High-Risk Prostate Cancer: Narrative Review of Current Understanding and New Directions.

Authors

Benjamin A. Greenberger, Thomas Jefferson UniversityFollow
Victor E. Chen, Thomas Jefferson UniversityFollow
Robert B. Den, Thomas Jefferson UniversityFollow

Document Type

Article

Publication Date

11-29-2019

Comments

This article is the author’s final published version in Frontiers in Oncology, Volume 9, November 2019, Article number 1273.

The published version is available at https://doi.org/10.3389/fonc.2019.01273. Copyright © Greenberger et al.

Publication made possible in part by support from the Thomas Jefferson University + Philadelphia University Open Access Fund

Abstract

Despite the many prospective randomized trials that have been available in the past decade regarding the optimization of radiation, hormonal, and surgical therapies for high-risk prostate cancer (PCa), many questions remain. There is currently a lack of level I evidence regarding the relative efficacy of radical prostatectomy (RP) followed by adjuvant radiation compared to radiation therapy (RT) combined with androgen deprivation therapy (ADT) for high-risk PCa. Current retrospective series have also described an improvement in biochemical outcomes and PCa-specific mortality through the use of augmented radiation strategies incorporating brachytherapy. The relative efficacy of modern augmented RT compared to RP is still incompletely understood. We present a narrative review regarding recent advances in understanding regarding comparisons of overall and PCa-specific mortality measures among patients with high-risk PCa treated with either an RP/adjuvant RT or an RT/ADT approach. We give special consideration to recent trends toward the assembly of multi-institutional series targeted at providing high-quality data to minimize the effects of residual confounding. We also provide a narrative review of recent studies examining brachytherapy boost and systemic therapies, as well as an overview of currently planned and ongoing studies that will further elucidate strategies for treatment optimization over the next decade.

Recommended Citation

Greenberger, Benjamin A.; Chen, Victor E.; and Den, Robert B., "Combined Modality Therapies for High-Risk Prostate Cancer: Narrative Review of Current Understanding and New Directions." (2019). Department of Radiation Oncology Faculty Papers. Paper 129.
https://jdc.jefferson.edu/radoncfp/129

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 License.

PubMed ID

31850194

Language

English