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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

  1. 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

  1. Ann Oncol. 1999 Jan;10(1):33-8 - PubMed
  2. J Clin Oncol. 2004 Mar 1;22(5):872-80 - PubMed
  3. Proc Natl Acad Sci U S A. 1980 Mar;77(3):1561-5 - PubMed
  4. Urology. 1996 Aug;48(2):249-60 - PubMed
  5. J Urol. 1997 Oct;158(4):1452-6 - PubMed
  6. Med Phys. 1994 Feb;21(2):303-13 - PubMed
  7. J Clin Oncol. 2001 May 1;19(9):2509-16 - PubMed
  8. Radiother Oncol. 2000 Jun;55(3):241-9 - PubMed
  9. Semin Oncol. 2013 Jun;40(3):297-307 - PubMed
  10. Prostate. 1984;5(1):93-100 - PubMed
  11. Int J Radiat Oncol Biol Phys. 1998 Jun 1;41(3):491-500 - PubMed
  12. Lancet. 2002 Jul 13;360(9327):103-6 - PubMed
  13. J Clin Oncol. 1992 Nov;10(11):1754-61 - PubMed
  14. J Clin Oncol. 1994 Dec;12(12):2682-6 - PubMed
  15. Urol Oncol. 2008 May-Jun;26(3):276-80 - PubMed
  16. J Clin Oncol. 2008 Jun 20;26(18):2973-8 - PubMed
  17. J Clin Oncol. 1998 Jan;16(1):275-83 - PubMed
  18. J Urol. 2001 Dec;166(6):2185-8 - PubMed
  19. J Natl Cancer Inst. 1999 Dec 15;91(24):2081-6 - PubMed
  20. Cancer Res. 1989 Aug 15;49(16):4640-7 - PubMed
  21. Clin Cancer Res. 1997 Dec;3(12 Pt 1):2431-8 - PubMed
  22. J Urol. 2006 Aug;176(2):548-53; discussion 553 - PubMed
  23. J Clin Oncol. 2013 Mar 1;31(7):845-52 - PubMed
  24. Urol Clin North Am. 2001 Aug;28(3):555-65 - PubMed
  25. J Clin Oncol. 1997 May;15(5):2040-9 - PubMed
  26. Int J Radiat Oncol Biol Phys. 1992;22(3):613-7 - PubMed
  27. Biochemistry. 1975 Dec 30;14(26):5586-92 - PubMed
  28. Br J Cancer. 2010 Mar 30;102(7):1123-8 - PubMed
  29. Cancer Res. 1991 Sep 15;51(18):4845-52 - PubMed
  30. Am J Clin Oncol. 2001 Feb;24(1):91-5 - PubMed
  31. J Clin Oncol. 2003 Mar 1;21(5):864-70 - PubMed
  32. Lancet. 1969 Dec 6;2(7632):1252-3 - PubMed
  33. J Urol. 2008 Apr;179(4):1354-60; discussion 1360-1 - PubMed
  34. Cancer J Sci Am. 1997 Sep-Oct;3(5):289-96 - PubMed
  35. J Clin Oncol. 1987 Aug;5(8):1232-9 - PubMed
  36. J Clin Oncol. 2008 Feb 1;26(4):585-91 - PubMed
  37. Radiother Oncol. 1988 Jun;12(2):129-40 - PubMed
  38. Anticancer Res. 1987 Nov-Dec;7(6):1165-71 - PubMed
  39. Int J Radiat Oncol Biol Phys. 2008 Jan 1;70(1):67-74 - PubMed
  40. J Natl Cancer Inst. 1994 Mar 16;86(6):441-6 - PubMed
  41. BJU Int. 2012 Dec;110(11 Pt B):E721-6 - PubMed
  42. JAMA. 1999 May 5;281(17):1623-7 - PubMed
  43. Int J Radiat Oncol Biol Phys. 1995 Apr 30;32(1):3-12 - PubMed
  44. Radiother Oncol. 1994 Sep;32(3):232-48 - PubMed
  45. Int J Radiat Oncol Biol Phys. 1991 Feb;20(2):207-11 - PubMed
  46. Int J Radiat Oncol Biol Phys. 1998 May 1;41(2):257-62 - PubMed
  47. Lancet. 2001 Sep 8;358(9284):781-6 - PubMed
  48. J Clin Oncol. 2000 May;18(9):1936-41 - PubMed
  49. Clin Genitourin Cancer. 2014 Apr;12(2):80-6 - PubMed
  50. Nouv Rev Fr Hematol. 1991;33(6):451-6 - PubMed
  51. CA Cancer J Clin. 2015 Jan-Feb;65(1):5-29 - PubMed
  52. Int J Radiat Oncol Biol Phys. 2001 Mar 1;49(3):699-703 - PubMed
  53. Cancer. 1993 Jun 1;71(11):3774-8 - PubMed
  54. Ann N Y Acad Sci. 1994 Nov 30;745:455-61 - PubMed
  55. Urology. 2007 Nov;70(5):931-5 - PubMed
  56. J Clin Oncol. 1999 Mar;17(3):958-67 - PubMed
  57. Int J Radiat Oncol Biol Phys. 1994 Jun 15;29(3):555-7 - PubMed
  58. Int J Radiat Oncol Biol Phys. 1990 Feb;18(2):489-91 - PubMed
  59. N Engl J Med. 1990 Oct 4;323(14):940-5 - PubMed
  60. J Clin Oncol. 2007 Jul 1;25(19):2804-10 - PubMed
  61. Radiother Oncol. 2010 Nov;97(2):312-7 - PubMed
  62. Semin Oncol. 1997 Dec;24(6 Suppl 19):S19-51-S19-56 - PubMed
  63. J Clin Oncol. 2004 May 15;22(10):1909-15 - PubMed
  64. J Clin Oncol. 1998 Apr;16(4):1310-7 - PubMed
  65. Int J Radiat Oncol Biol Phys. 1994 Jun 15;29(3):565-9 - PubMed
  66. Int J Radiat Oncol Biol Phys. 1992;24(3):519-25 - PubMed
  67. Urology. 2004 Jul;64(1):90-4 - PubMed
  68. Prostate. 1994;24(1):39-45 - PubMed
  69. Semin Radiat Oncol. 1999 Apr;9(2 Suppl 1):12-26 - PubMed
  70. Radiother Oncol. 1994 Aug;32(2):124-8 - PubMed
  71. Cancer Res. 1996 Apr 15;56(8):1842-50 - PubMed
  72. Ann Intern Med. 1989 Aug 15;111(4):273-9 - PubMed
  73. JAMA. 1998 Sep 16;280(11):969-74 - PubMed

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