Radiation and hormonal therapy for locally advanced and clinically localized prostate cancer

Patients with locally advanced prostate cancer (TNM clinical stage T3, T4) who were treated using external-beam radiotherapy (EBRT) and 3 years of androgen deprivation therapy (ADT) were compared with patients treated with EBRT alone and were shown to have a survival benefit. Studies that address the same question for patients with clinically localized disease (stage T1, T2) have been completed and are awaiting follow-up study. A rate of decrease in the serum hemoglobin level of > or =1 g/dL during the first month of neoadjuvant ADT predicted for a significantly worse disease-free survival outcome, as defined by the prostate-specific antigen, for patients with intermediate- and high-risk clinically localized disease who were undergoing EBRT and ADT. Validation of this predictive factor by others is needed.