The neoadjuvant hormonal therapy in prostate cancer treatment

Zhernov A.A., Sivkov A.V., Oschepkov V.N., Keshishev N.G.

Radical prostatectomy – is one of the main methods of the treatment for prostate cancer. One of undecided is a problem of the possibility and practicability of the prostatectomy for locally advanced prostate cancer. Some authors recommend conservative (external beam or hormonal) treatment. Th e other studies demonstrate the advantage of the operative method for T3 tumors. Presented meta-analisis has shown that combination neoadjuvant hormonal therapy with surgery does not provide the statistical signifi cant advantage in clinical outcome. According to published data, the main advantage of the using to combinations hormonal therapy and radical operation is considered possibility of the positive surgical margin reduction. Four studies, came in meta-analysis and comprised of the general 1865 patients, have shown that hormonal treatment before external beam therapy increasing the disease free period. Necessary to note that in majority publication about neoadjuvant hormonal therapy results are analysed relatively small number patient with locally advanced prostate cancer. Besides, patients were divided on cohorts only on treatment method, herewith formed groups were not shown uniform, since in each diff erent progression risk tumors were present. Th e questions remain undecided about use analogue LHRH as single agent or with antiandrogens, as well as about duration of hormonal treatment. Th e other important area of the current clinical studies includes the determination role of combination hormons and beam therapy, as well as mode androgen deprivation in combinations with modern chemotherapy.

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