prostate-report.org

Neoadjuvant hormone therapy in localized and locally advanced prostate cancer

Neoadjuvant hormone therapy is the use of hormone therapy immediately preceding some other form of therapeutic intervention, such as external beam radiation, brachytherapy, or radical surgery.

Cochrane Urological Cancers Unit has just published a detailed review and assessment of the value of hormone therapy in neoadjuvant management of localized and locally advanced prostate cancer.

The basic conclusions of this review appear to be as follows:

– Neoadjuvant hormone therapy (NHT) is associated with significant clinical benefit when given with radiotherapy
– NHT prior to prostatectomy does not improve overall or disease-free survival
– NHT does improve pathological outcomes (including positive margin rates, organ confinement, and lymph node invasiona) when used prior to prostatectomy but — as indicated above — this does not appear to affect patient survival

The reviewers also conclude that, “The decision to use hormone therapy should be discussed between the patient, the clinician and policy maker based on the benefits, toxicity and cost.”