Treatment of Localized or Locally Advanced Prostate Cancer: The Clinical Use of Radiotherapy

Abstract

Prostate cancer raises an important problem in public health due to its frequency, the opportunity of individual screening provided the patient is informed, its probability of cure for localized disease, the various therapeutic strategies which are offered to the patient, all of which finally require a multidisciplinary approach. Surgery remains the standard for young men with localized disease with a low or intermediate risk; optimized modalities of radiotherapy—3D conformal radiotherapy (3DCRT) and IMRT given in centres of excellence—are other options which offer the same efficacy; brachytherapy may be available for a very well defined cohort of patients. For locally advanced prostate cancer, many randomized trials have shown that the combination of hormonal treatment with LHRH analogue and external irradiation definitely improves overall survival, with a long term adjuvant setting for the poor and intermediate risk group risk and a short term for the low risk group. Clinical research remains mandatory for optimization of treatment modalities.