Chapter 45 – Neoadjuvant Hormonal Treatment Prior to Curative Treatment in Prostate Cancer

摘要: Radical prostatectomy is widely performed in patients with early, locally confined prostate cancer and may lead to cure of the disease, provided that all malignant cells are removed. Given well-known androgen sensitivity cancer, neoadjuvant hormonal treatment has been explored as a way increase rate organ-confined disease ultimately potentially improve progression survival. Neoadjuvant prior radical lowers positive surgical margins, decreases likelihood nodes, clinically downstages tumor one-third but, ultimately, does not decrease number prostate-specific antigen (PSA) statistically significant manner. One main advantages this reduction size thereby smaller volume tissue be irradiated. This can beneficial reducing acute long-term complications associated dose reduce clonogens need eradicated by radiation. also enhance cell death common mechanisms, remove from active cycling phase resting phase, inhibit angiogenesis bulk reduction, improving oxygenation remaining clonogenic cells.