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Prostate Cancer
Volume 2016, Article ID 2420786, 12 pages
http://dx.doi.org/10.1155/2016/2420786
Review Article

Evolving Paradigm of Radiotherapy for High-Risk Prostate Cancer: Current Consensus and Continuing Controversies

1Cleveland Clinic, Taussig Cancer Institute, Department of Radiation Oncology, Cleveland, OH, USA
2Cleveland Clinic, Taussig Cancer Institute, Department of Radiation Oncology, Strongsville, OH, USA

Received 27 November 2015; Revised 16 April 2016; Accepted 24 April 2016

Academic Editor: Craig Robson

Copyright © 2016 Aditya Juloori et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

High-risk prostate cancer is an aggressive form of the disease with an increased risk of distant metastasis and subsequent mortality. Multiple randomized trials have established that the combination of radiation therapy and long-term androgen deprivation therapy improves overall survival compared to either treatment alone. Standard of care for men with high-risk prostate cancer in the modern setting is dose-escalated radiotherapy along with 2-3 years of androgen deprivation therapy (ADT). There are research efforts directed towards assessing the efficacy of shorter ADT duration. Current research has been focused on assessing hypofractionated and stereotactic body radiation therapy (SBRT) techniques. Ongoing randomized trials will help assess the utility of pelvic lymph node irradiation. Research is also focused on multimodality therapy with addition of a brachytherapy boost to external beam radiation to help improve outcomes in men with high-risk prostate cancer.