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

The authors Shipley et al. (1917) report on the results of a phase-3 RTOG-Study, which demonstrates, that a 24-monthsanti androgen therapy with daily bicalutamide in addition to salvage radiotherapy prolongs in high risk patients (highPSA-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 evaluationof the data of the Martini-clinic in Hamburg yielded that a radical prostatectomy leads in 9% to an incontinence (>1pads/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 immediatepostoperative radiotherapy should be chosen or, still better, a primary radiotherapy should be preferred in patients withmedian or high risk.