Русаков И.Г.

Introduction. Despite the disappointing statistics of morbidity and mortality rates, prostate cancer is a slow growing tumor and does not always lead to death. Thus, it is of paramountimportance for oncologiststo decidewho should receive aggressive treatment ofrapidly progressing prostate cancer and who should undergo gentle treatment orjust monitoring due to the slowgrowing form of tumor,which isless dangerousfor one’slife.

Current guidelines recommend to maintain the target level of testosterone (T) during hormone therapy not higher than 1.73 nmol/l (50 ng/dl). However, in the majority of patients who undergo surgical castration (SC), concentration of T reaches < 0,694 nmol/l (< 20 ng/dl), but these levels are rarely attainable in patients on analogues of luteinizing hormone-releasing hormone (LHRH). It is likely that the hormone therapy should aim at reduction of T in plasma lower than it is being recommended currently.

This article is a review of the last randomized trials, devoted to the assessment and standardization of the neoadjuvant and adjuvant androgen deprivation models in combination with the external radiation therapy. The patients with the low risk of progression are characterized as prognosisperspective independent of the type of the hormonal/radiation therapy. Intermediate and high risk patients are the group, that needs more strict risk stratification.