[Radiotherapy of prostate carcinoma]

Area of Science:

• Oncology
• Radiation Oncology

Background:

• External beam radiotherapy (EBRT) is a curative option for non-metastasized prostate cancer, comparable to radical prostatectomy in early stages.
• Conventional fractionated RT with doses ≥70 Gy yields high 2-year biological no-evidence of disease (bNED) rates, particularly in low-risk stages.

Purpose of the Study:

• To evaluate the efficacy and outcomes of external beam radiotherapy (EBRT) in treating non-metastasized prostate cancer.
• To assess the role of EBRT in different tumor stages and its comparison with radical prostatectomy.
• To explore the potential benefits and drawbacks of combined hormonal and radiation therapy, and adjuvant EBRT.

Main Methods:

• Review of existing studies on external beam radiotherapy (EBRT) for prostate cancer.
• Analysis of recurrence-free survival rates based on tumor stage (T1-T3) and lymph node status (Nx, pNO).
• Comparison of conformal vs. conventional EBRT planning and evaluation of sequelae.

Main Results:

• EBRT achieves high bNED rates (>90% in low-risk, ~50% in medium-risk stages).
• Ten-year recurrence-free survival is 43-76% in T1-T2 Nx stages and ~90% in T1b-T2 pNO stages.
• Conformal EBRT demonstrates an advantage over conventional planning with severe sequelae in <5% of patients.

Conclusions:

• EBRT is a highly effective treatment for non-metastasized prostate cancer, with conformal planning improving outcomes and minimizing side effects.
• The role of hormonal therapy in conjunction with EBRT requires further investigation, potentially being superfluous in early stages but beneficial in locally advanced disease.
• Participation in ongoing studies is crucial to clarify the value of postoperative EBRT, pelvic lymph node irradiation, dose escalation, and combined therapies.