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What is the optimal duration of ADT for unfavorable intermediate risk or high risk localized prostate cancer treated with SBRT instead of conventionally fractionated or hypofractionated RT?

Do you also give neoadjuvant, concurrent, and adjuvant ADT in the same manner as for non-SBRT EBRT?
5 Answers
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Medical Oncology · Duke University School of Medicine
Answered on

There is no available data from randomized trials to support any modification in the choice of ADT (GnRH agonist vs antagonist) or use of abiraterone acetate, or on the duration of ADT (4-6 mo vs 2-3 years) based on the form of radiation, and thus I follow the NCCN guidelines that provide recommenda...

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Radiation Oncology
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Intermediate Risk

The available phase III data validating SBRT does not include concurrent ADT, however, I typically recommend the same duration of ADT as for fractionated EBRT based on generalization from this literature. I am not aware of any comparative trials proving the additional efficacy of AD...

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Radiation Oncology · David Geffen School of Medicine at UCLA
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This is a timely question. Currently, there are no published data to suggest that the duration of ADT can be altered in the context of ultrahypofractionation for either UIR or HR disease. Fundamentally, two facts and/or realities of evidence must be appreciated. First, it must be recognized that thu...

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Radiation Oncology · West Virginia University
Answered on

Good discussion.

Perhaps the more pressing question we should be asking our urology colleagues is why they don't routinely offer medical intervention or refer to someone who will offer one when their surgical patients have UIR or more commonly, high or very high risk disease.

There seems to be a dis...

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Medical Oncology · Myo Thant, MD
Answered on

Will give ADT based upon current NCCN guidelines.

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