Modern Radiotherapy for High-Risk and Very-High-Risk Prostate Adenocarcinoma

Area of Science:

• Oncology
• Radiation Oncology
• Genitourinary Cancer

Background:

• High-risk prostate cancer treatment has evolved with modern radiotherapy techniques.
• Current approaches include dose escalation and pelvic nodal irradiation.
• Androgen-deprivation therapy intensification is also being explored.

Purpose of the Study:

• To summarize advancements in radiotherapy for high-risk prostate cancer.
• To highlight the role of genomic risk stratification in treatment deintensification or intensification.
• To discuss the integration of radiotherapy and androgen-deprivation therapy.

Main Methods:

• Review of current radiotherapy strategies for high-risk prostate cancer.
• Discussion of novel genomic tools for risk stratification.
• Analysis of treatment intensification and deintensification studies.

Main Results:

• Modern radiotherapy allows for fewer treatment sessions and selectively higher doses.
• Elective pelvic nodal treatment is an option for select patients.
• Genomic tools are guiding personalized treatment intensification or deintensification of radiotherapy and androgen-deprivation therapy.

Conclusions:

• Radiotherapy for high-risk prostate cancer is becoming more precise and personalized.
• Genomic stratification is key to optimizing treatment deintensification or intensification.
• Future research focuses on tailoring combined radiotherapy and androgen-deprivation therapy.