Should the use of a brachytherapy boost affect the duration or use of ADT in intermediate or high risk prostate cancer?

Topics: Radiation Oncology • Genitourinary Cancers

Does the 1 year of ADT used in the ASCENDE-RT trial present a new option of the standard of care in timing ADT when combined with brachtherapy boost?

Answer from: Radiation Oncologist at Academic Institution

We traditionally think of 4-6 mo ADT for intermediate risk, and 18-36 mo ADT for high risk men treated with EBRT (whether dose escalated or not). For high risk men in our practice, I have usually recommended 28 mo (from RTOG 9202) ADT as a standard. I do think it is fair to consider a course <28 ...

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Radiation Oncologist at CoxHealth Radiation Oncology
Thank you for posting this important question and ...

Answer from: Radiation Oncologist at Academic Institution

@Stanley Liauw has summarized the issues well. My overall sense is the main benefit of ADT in combination with RT is on local disease. So, in the setting of a brachy boost, I generally use NO ADT in intermediate risk patients as well as the low end of high risk (e.g. favorable factors aside from Gle...

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Radiation Oncologist at Providence St Mary Cancer Center
How do the NCCN guideline panel members justify th...

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