World J Clin Oncol. 2015 Aug 10;6(4):35-42. doi: 10.5306/wjco.v6.i4.35.
Concurrent chemoradiation for high-risk prostate cancer.
World journal of clinical oncology
Benjamin T Cooper, Nicholas J Sanfilippo
Affiliations
Affiliations
- Benjamin T Cooper, Nicholas J Sanfilippo, Department of Radiation Oncology, New York University School of Medicine, New York, NY 10016, United States.
PMID: 26266099
PMCID: PMC4530376 DOI: 10.5306/wjco.v6.i4.35
Abstract
There are estimated to be 220800 cases of prostate cancer diagnosed in 2015, making up 26% of all cancer diagnoses. Fortunately, adenocarcinoma of the prostate is often a highly treatable malignancy. Even though the majority of prostate cancer patients present with localized disease, prostate cancer still accounts for over 27000 deaths a year. There is a subset of patients that are likely to recur after locoregional treatment that is thought of as a "high-risk" population. This more aggressive subset includes patients with clinical stage greater than T2b, Gleason score greater than 7, and prostate specific antigen greater than 20 ng/dL. The rate of biochemical relapse in this high risk group is 32%-70% within five years of definitive focal therapy. Given these discouraging outcomes, attempts have been made to improve cure rates by radiation dose escalation, addition of androgen depravation therapy, and addition of chemotherapy either sequentially or concurrently with radiation. One method that has been shown to improve clinical outcomes is the addition of chemotherapy to radiotherapy for definitive treatment. Concurrent chemoradiation with 5-fluorouracil, estramustine phosphate, vincristine, docetaxel, and paclitaxel has been studied in the phase I and/or II setting. These trials have identified the maximum tolerated dose of chemotherapy and radiation that can be safely delivered concurrently and established the safety and feasibility of this technique. This review will focus on the addition of concurrent chemotherapy to radiotherapy in the definitive management of high-risk prostate cancer.
Keywords: Chemoradiation; Chemotherapy; Concurrent chemotherapy; High-risk prostate cancer; Intensity modulated radiation therapy; Prostate cancer
References
- Ann Oncol. 1999 Jan;10(1):33-8 - PubMed
- J Clin Oncol. 2004 Mar 1;22(5):872-80 - PubMed
- Proc Natl Acad Sci U S A. 1980 Mar;77(3):1561-5 - PubMed
- Urology. 1996 Aug;48(2):249-60 - PubMed
- J Urol. 1997 Oct;158(4):1452-6 - PubMed
- Med Phys. 1994 Feb;21(2):303-13 - PubMed
- J Clin Oncol. 2001 May 1;19(9):2509-16 - PubMed
- Radiother Oncol. 2000 Jun;55(3):241-9 - PubMed
- Semin Oncol. 2013 Jun;40(3):297-307 - PubMed
- Prostate. 1984;5(1):93-100 - PubMed
- Int J Radiat Oncol Biol Phys. 1998 Jun 1;41(3):491-500 - PubMed
- Lancet. 2002 Jul 13;360(9327):103-6 - PubMed
- J Clin Oncol. 1992 Nov;10(11):1754-61 - PubMed
- J Clin Oncol. 1994 Dec;12(12):2682-6 - PubMed
- Urol Oncol. 2008 May-Jun;26(3):276-80 - PubMed
- J Clin Oncol. 2008 Jun 20;26(18):2973-8 - PubMed
- J Clin Oncol. 1998 Jan;16(1):275-83 - PubMed
- J Urol. 2001 Dec;166(6):2185-8 - PubMed
- J Natl Cancer Inst. 1999 Dec 15;91(24):2081-6 - PubMed
- Cancer Res. 1989 Aug 15;49(16):4640-7 - PubMed
- Clin Cancer Res. 1997 Dec;3(12 Pt 1):2431-8 - PubMed
- J Urol. 2006 Aug;176(2):548-53; discussion 553 - PubMed
- J Clin Oncol. 2013 Mar 1;31(7):845-52 - PubMed
- Urol Clin North Am. 2001 Aug;28(3):555-65 - PubMed
- J Clin Oncol. 1997 May;15(5):2040-9 - PubMed
- Int J Radiat Oncol Biol Phys. 1992;22(3):613-7 - PubMed
- Biochemistry. 1975 Dec 30;14(26):5586-92 - PubMed
- Br J Cancer. 2010 Mar 30;102(7):1123-8 - PubMed
- Cancer Res. 1991 Sep 15;51(18):4845-52 - PubMed
- Am J Clin Oncol. 2001 Feb;24(1):91-5 - PubMed
- J Clin Oncol. 2003 Mar 1;21(5):864-70 - PubMed
- Lancet. 1969 Dec 6;2(7632):1252-3 - PubMed
- J Urol. 2008 Apr;179(4):1354-60; discussion 1360-1 - PubMed
- Cancer J Sci Am. 1997 Sep-Oct;3(5):289-96 - PubMed
- J Clin Oncol. 1987 Aug;5(8):1232-9 - PubMed
- J Clin Oncol. 2008 Feb 1;26(4):585-91 - PubMed
- Radiother Oncol. 1988 Jun;12(2):129-40 - PubMed
- Anticancer Res. 1987 Nov-Dec;7(6):1165-71 - PubMed
- Int J Radiat Oncol Biol Phys. 2008 Jan 1;70(1):67-74 - PubMed
- J Natl Cancer Inst. 1994 Mar 16;86(6):441-6 - PubMed
- BJU Int. 2012 Dec;110(11 Pt B):E721-6 - PubMed
- JAMA. 1999 May 5;281(17):1623-7 - PubMed
- Int J Radiat Oncol Biol Phys. 1995 Apr 30;32(1):3-12 - PubMed
- Radiother Oncol. 1994 Sep;32(3):232-48 - PubMed
- Int J Radiat Oncol Biol Phys. 1991 Feb;20(2):207-11 - PubMed
- Int J Radiat Oncol Biol Phys. 1998 May 1;41(2):257-62 - PubMed
- Lancet. 2001 Sep 8;358(9284):781-6 - PubMed
- J Clin Oncol. 2000 May;18(9):1936-41 - PubMed
- Clin Genitourin Cancer. 2014 Apr;12(2):80-6 - PubMed
- Nouv Rev Fr Hematol. 1991;33(6):451-6 - PubMed
- CA Cancer J Clin. 2015 Jan-Feb;65(1):5-29 - PubMed
- Int J Radiat Oncol Biol Phys. 2001 Mar 1;49(3):699-703 - PubMed
- Cancer. 1993 Jun 1;71(11):3774-8 - PubMed
- Ann N Y Acad Sci. 1994 Nov 30;745:455-61 - PubMed
- Urology. 2007 Nov;70(5):931-5 - PubMed
- J Clin Oncol. 1999 Mar;17(3):958-67 - PubMed
- Int J Radiat Oncol Biol Phys. 1994 Jun 15;29(3):555-7 - PubMed
- Int J Radiat Oncol Biol Phys. 1990 Feb;18(2):489-91 - PubMed
- N Engl J Med. 1990 Oct 4;323(14):940-5 - PubMed
- J Clin Oncol. 2007 Jul 1;25(19):2804-10 - PubMed
- Radiother Oncol. 2010 Nov;97(2):312-7 - PubMed
- Semin Oncol. 1997 Dec;24(6 Suppl 19):S19-51-S19-56 - PubMed
- J Clin Oncol. 2004 May 15;22(10):1909-15 - PubMed
- J Clin Oncol. 1998 Apr;16(4):1310-7 - PubMed
- Int J Radiat Oncol Biol Phys. 1994 Jun 15;29(3):565-9 - PubMed
- Int J Radiat Oncol Biol Phys. 1992;24(3):519-25 - PubMed
- Urology. 2004 Jul;64(1):90-4 - PubMed
- Prostate. 1994;24(1):39-45 - PubMed
- Semin Radiat Oncol. 1999 Apr;9(2 Suppl 1):12-26 - PubMed
- Radiother Oncol. 1994 Aug;32(2):124-8 - PubMed
- Cancer Res. 1996 Apr 15;56(8):1842-50 - PubMed
- Ann Intern Med. 1989 Aug 15;111(4):273-9 - PubMed
- JAMA. 1998 Sep 16;280(11):969-74 - PubMed
Publication Types