Role of Radiotherapy and Hormone Therapy in Patients with Node-Positive Locally Advanced Prostate Cancer

Area of Science:

• Oncology
• Urology
• Radiotherapy

Background:

• Advanced imaging and surgical techniques increase detection of node-positive prostate cancer (PCa) at diagnosis or post-surgery.
• Treatment for PCa with positive regional nodes has shifted towards combining systemic and locoregional therapies for improved survival.
• Limited randomized trial evidence necessitates a review of current management strategies.

Purpose of the Study:

• To review current evidence for managing node-positive prostate cancer.
• To summarize findings for patients diagnosed initially or post-surgery.
• To evaluate imaging, radiotherapy, and hormonal treatment options.

Main Methods:

• Comprehensive literature search across major databases (MEDLINE, PubMed, EMBASE, etc.) conducted in January 2023.
• Keywords included "Prostatic Neoplasms", "Node-positive", "Radiotherapy", and hormonal therapy terms (MeSH and Text Word).
• No restrictions on publication date or language were applied.

Main Results:

• No definitive consensus exists for managing node-positive PCa at initial diagnosis or after surgery.
• Existing literature was reviewed for imaging, radiotherapy, and hormonal treatments in these scenarios.
• Current management strategies are summarized based on available evidence.

Conclusions:

• The combination of radiotherapy and androgen-deprivation therapy is the preferred treatment approach.
• Second-generation hormone therapies and intensified radiotherapy schedules are expected to evolve treatment paradigms.
• Further research and clinical trials are needed to establish definitive treatment protocols.