Cancer UrologyCancer UrologyОнкоурология1726-97761996-1812Publishing House ABV Press36510.17650/1726-9776-2012-8-4-77-82PROSTATE CANCERРАК ПРЕДСТАТЕЛЬНОЙ ЖЕЛЕЗЫCOMBINATION THERAPY FOR PROSTATE CANCER: CLINICAL OBSERVATIONSКОМБИНИРОВАННОЕ ЛЕЧЕНИЕ РАКА ПРЕДСТАТЕЛЬНОЙ ЖЕЛЕЗЫ: КЛИНИЧЕСКИЕ НАБЛЮДЕНИЯAlekseevB. Ya.АлексеевБ. Я.
Russian Federation
byalekseev@mail.ruNyushkoK. M.НюшкоК. М.
Russian Federation
byalekseev@mail.ruP.A. Herzen Moscow Oncology Research InstituteМНИОИ им. П.А. Герцена301220128477820808201408082014https://oncourology.abvpress.ru/oncur/article/view/365

Prostate cancer (PC) is one of the urgent problems of modern urological oncology. The incidence of this pathology is steadily growing worldwide. Despite the fact that PSA diagnosis is extensively used and programs for the early detection of this disease are introduced, the rate of dia gnosis of advanced PC forms remains high. Furthermore, a number of aspects of therapy for this disease remain controversial so far. The 7 th Congress of the Russian Society of Urological Oncologists, which dealt with some issues of combination therapy for locally advanced PC, was held in Moscow in October 3 to 5, 2012. The paper covers a number of controversial issues in the management of patients with PC in different clinical situations.

Рак предстательной железы (РПЖ) является одной из актуальных проблем современной онкоурологии. Заболеваемость данной патологией неуклонно растет во всем мире. Несмотря на широкое использование ПСА-диагностики и введения программ, направленных на раннее выявление данного заболевания, частота диагностики запущенных форм РПЖ остается высокой. Кроме того, ряд аспектов терапии данного заболевания до настоящего момента остается спорным. С 3 по 5 октября 2012 г. в Москве состоялся VII конгресс Российского общества онкоурологов, на котором освещались некоторые вопросы комбинированного лечения местно-распространенных форм РПЖ. В статье освещен ряд спорных вопросов при проведении терапии больных РПЖ в различных клинических ситуациях.

prostate cancercombination treatmenthormone and radiation therapyclinical caseрак предстательной железыкомбинированное лечениегормонолучевая терапияклинический случай1. Yossepowitch O., Eggener S.E., Bianco F.J. Jr et al. Radical prostatectomy for clinically localized, high risk prostate cancer: critical analysis of risk assessment methods. J Urol 2007;178(2):493−9.Yossepowitch O., Eggener S.E., Bianco F.J. Jr et al. Radical prostatectomy for clinically localized, high risk prostate cancer: critical analysis of risk assessment methods. J Urol 2007;178(2):493−9.2. D’Amico A.V., Whittington R., Malkowicz S.B. et al. Pretreatment nomogram for prostate-specific antigen recurrence after radical prostatectomy or external-beam radiation therapy for clinically localized prostate cancer. J Clin Oncol 1999; 17(1):168−72.D’Amico A.V., Whittington R., Malkowicz S.B. et al. Pretreatment nomogram for prostate-specific antigen recurrence after radical prostatectomy or external-beam radiation therapy for clinically localized prostate cancer. J Clin Oncol 1999; 17(1):168−72.3. Lawton C.A., Winter K., Murray K. et al. Updated results of the phase III Radiation Therapy Oncology Group (RTOG) trial 85-31 evaluating the potential benefit of androgen suppression following standard radiation therapy for unfavorable prognosis carcinoma of the prostate. Int J Radiat Oncol Biol Phys 2001;49(4):937−46.Lawton C.A., Winter K., Murray K. et al. Updated results of the phase III Radiation Therapy Oncology Group (RTOG) trial 85-31 evaluating the potential benefit of androgen suppression following standard radiation therapy for unfavorable prognosis carcinoma of the prostate. Int J Radiat Oncol Biol Phys 2001;49(4):937−46.4. Pilepich M.V., Winter K., John M.J. et al. Phase III radiation therapy oncology group (RTOG) trial 86-10 of androgen deprivation adjuvant to definitive radiotherapy in locally advanced carcinoma of the prostate. Int J Radiat Oncol Biol Phys 2001;50(5):1243−52.Pilepich M.V., Winter K., John M.J. et al. Phase III radiation therapy oncology group (RTOG) trial 86-10 of androgen deprivation adjuvant to definitive radiotherapy in locally advanced carcinoma of the prostate. Int J Radiat Oncol Biol Phys 2001;50(5):1243−52.5. Bolla M., Gonzalez D., Warde P. et al. Improved survival in patients with locally advanced prostate cancer treated with radiotherapy and goserelin. N Engl J Med 1997;337(5):295−300.Bolla M., Gonzalez D., Warde P. et al. Improved survival in patients with locally advanced prostate cancer treated with radiotherapy and goserelin. N Engl J Med 1997;337(5):295−300.6. Hanks G.E., Lu J., Machtay M. et al. RTOG protocol 92-02: A phase III trial of the use of long term androgen suppression following neoadjuvant hormonal cytoreduction and radiotherapy in locallyadvanced carcinoma of the prostate. Proc Am Soc Clin Oncol 2000:19:1284.Hanks G.E., Lu J., Machtay M. et al. RTOG protocol 92-02: A phase III trial of the use of long term androgen suppression following neoadjuvant hormonal cytoreduction and radiotherapy in locallyadvanced carcinoma of the prostate. Proc Am Soc Clin Oncol 2000:19:1284.7. Ward J.F., Slezak J.M., Blute M.L. et al. Radical prostatectomy for clinically advanced (cT3) prostate cancer since the advent of prostate-specific antigen testing: 15-year outcome. BJU Int 2005;95(6):751−6.Ward J.F., Slezak J.M., Blute M.L. et al. Radical prostatectomy for clinically advanced (cT3) prostate cancer since the advent of prostate-specific antigen testing: 15-year outcome. BJU Int 2005;95(6):751−6.8. Weckermann D., Hamm M., Dorn R. et al. Sentinel lymph node dissection in prostate cancer. Experience after more than 800 interventions. Urologe A 2006;45(6):723−7.Weckermann D., Hamm M., Dorn R. et al. Sentinel lymph node dissection in prostate cancer. Experience after more than 800 interventions. Urologe A 2006;45(6):723−7.9. Klevecka V., Musch M., Roggenbuck U. et al – Extended pelvic node dissection allows better identification of lymph node metastasis in patients with clinically localized prostate cancer. J Urol 2006;175:450.Klevecka V., Musch M., Roggenbuck U. et al – Extended pelvic node dissection allows better identification of lymph node metastasis in patients with clinically localized prostate cancer. J Urol 2006;175:450.10. Heidenreich A., Von Klobloch R., Varga Z. et al. Extended pelvic lymphadenectomy in men undergoing radical retropubic prostatectomy (RRP) – an update on > 300 cases. J Urol 2004;171:312.Heidenreich A., Von Klobloch R., Varga Z. et al. Extended pelvic lymphadenectomy in men undergoing radical retropubic prostatectomy (RRP) – an update on > 300 cases. J Urol 2004;171:312.11. Bader P., Burkhard F.C., Markwalder R., Studer U.E. Disease progression and survival of patients with positive lymph nodes after radical prostatectomy. Is there a chance of cure? J Urol 2003;169(3):849−54.Bader P., Burkhard F.C., Markwalder R., Studer U.E. Disease progression and survival of patients with positive lymph nodes after radical prostatectomy. Is there a chance of cure? J Urol 2003;169(3):849−54.12. Schulman C.C., Debruyne F.M., Forster G. et al. 4-Year follow-up results of a European prospective randomized study on neoadjuvant hormonal therapy prior to radical prostatectomy in T2-3N0M0 prostate cancer. European Study Group on Neoadjuvant Treatment of Prostate Cancer. Eur Urol 2000; 38(6):706−13.Schulman C.C., Debruyne F.M., Forster G. et al. 4-Year follow-up results of a European prospective randomized study on neoadjuvant hormonal therapy prior to radical prostatectomy in T2-3N0M0 prostate cancer. European Study Group on Neoadjuvant Treatment of Prostate Cancer. Eur Urol 2000; 38(6):706−13.13. Soloway M.S., Pareek K., Sharifi R. et al. Neoadjuvant androgen ablation before radical prostatectomy in cT2bNxMo prostate cancer: 5-year results. J Urol 2002;167(1):112−6.Soloway M.S., Pareek K., Sharifi R. et al. Neoadjuvant androgen ablation before radical prostatectomy in cT2bNxMo prostate cancer: 5-year results. J Urol 2002;167(1):112−6.14. Gleave M.E., Goldenberg S.L., Chin J.L. et al. Randomized comparative study of 3 versus 8-month neoadjuvant hormonal therapy before radical prostatectomy: biochemical and pathological effects. J Urol 2001;166(2):500−6.Gleave M.E., Goldenberg S.L., Chin J.L. et al. Randomized comparative study of 3 versus 8-month neoadjuvant hormonal therapy before radical prostatectomy: biochemical and pathological effects. J Urol 2001;166(2):500−6.15. Messing E.M., Manola J., Yao J. et al. Immediate versus deferred androgen deprivation treatment in patients with node-positive prostate cancer after radical prostatectomy and pelvic lymphadenectomy. Lancet Oncol 2006;7(6):472−9.Messing E.M., Manola J., Yao J. et al. Immediate versus deferred androgen deprivation treatment in patients with node-positive prostate cancer after radical prostatectomy and pelvic lymphadenectomy. Lancet Oncol 2006;7(6):472−9.16. Ghavamian R., Bergstralh E.J., Blute M.L. et al. Radical retropubic prostatectomy plus orchiectomy versus orchiectomy alone for pTxN+ prostate cancer: a matched comparison. J Urol 1999;161:1223−8.Ghavamian R., Bergstralh E.J., Blute M.L. et al. Radical retropubic prostatectomy plus orchiectomy versus orchiectomy alone for pTxN+ prostate cancer: a matched comparison. J Urol 1999;161:1223−8.17. Dorff T.B., Flaig T.W., Tangen C.M. et al. Adjuvant androgen deprivation for high-risk prostate cancer after radical prostatectomy: SWOG S9921 study. J Clin Oncol 2011; 29(15):2040−5.Dorff T.B., Flaig T.W., Tangen C.M. et al. Adjuvant androgen deprivation for high-risk prostate cancer after radical prostatectomy: SWOG S9921 study. J Clin Oncol 2011; 29(15):2040−5.18. Wiegel T., Bottke D., Steiner U. et al. Phase III postoperative adjuvant radiotherapy after radical prostatectomy compared with radical prostatectomy alone in pT3 prostate cancer with postoperative undetectable prostate-specific antigen: ARO 96-02/AUO AP 09/95. J Clin Oncol 2009;27:2924−30.Wiegel T., Bottke D., Steiner U. et al. Phase III postoperative adjuvant radiotherapy after radical prostatectomy compared with radical prostatectomy alone in pT3 prostate cancer with postoperative undetectable prostate-specific antigen: ARO 96-02/AUO AP 09/95. J Clin Oncol 2009;27:2924−30.19. Bolla M., Van Poppel H., Collette L. et al. Postoperative radiotherapy after radical prostatectomy: a randomized controlled trial (EORTC trial 22911). Lancet 2005;366:572−8.Bolla M., Van Poppel H., Collette L. et al. Postoperative radiotherapy after radical prostatectomy: a randomized controlled trial (EORTC trial 22911). Lancet 2005;366:572−8.20. Nudell D.M., Grossfeld G.D., Weinberg V.K. et al. Radiotherapy after radical prostatectomy: treatment outcomes and failure patterns. Urology 1999;54(6):1049−57.Nudell D.M., Grossfeld G.D., Weinberg V.K. et al. Radiotherapy after radical prostatectomy: treatment outcomes and failure patterns. Urology 1999;54(6):1049−57.21. Zietman A.L., Prince E.A., Nakfoor B.M.et al. Androgen deprivation and radiation therapy. Int J Radiat Oncol Biol Phys 1997; 38(5):1067−70.Zietman A.L., Prince E.A., Nakfoor B.M.et al. Androgen deprivation and radiation therapy. Int J Radiat Oncol Biol Phys 1997; 38(5):1067−70.22. Roach M. 3rd, Bae K., Speight J. et al. Short-term neoadjuvant androgen deprivation therapy and external-beam radiotherapy for locally advanced prostate cancer: long-term results of RTOG 8610. J Clin Oncol 2008; 26(4):585−91.Roach M. 3rd, Bae K., Speight J. et al. Short-term neoadjuvant androgen deprivation therapy and external-beam radiotherapy for locally advanced prostate cancer: long-term results of RTOG 8610. J Clin Oncol 2008; 26(4):585−91.23. Porter A.T., Elhilali M., Manji M. et al. A phase III randomized trial to evaluate the efficacy of neoadjuvant therapy prior to curative radiotherapy in locally advanced prostate cancer patients. A Canadian Urologic Oncology Group study. Proc Am Soc Clin Oncol 1997;16 (Abstr. 1123).Porter A.T., Elhilali M., Manji M. et al. A phase III randomized trial to evaluate the efficacy of neoadjuvant therapy prior to curative radiotherapy in locally advanced prostate cancer patients. A Canadian Urologic Oncology Group study. Proc Am Soc Clin Oncol 1997;16 (Abstr. 1123).24. Denham J.W., Steigler A., Lamb D.S. et al. Short-term androgen deprivation and radiotherapy for locally advanced prostate cancer: results from the Trans-Tasman Radiation Oncology Group 96.01 randomised cont rolled trial. Lancet Oncol 2005; 6(11):841−50.Denham J.W., Steigler A., Lamb D.S. et al. Short-term androgen deprivation and radiotherapy for locally advanced prostate cancer: results from the Trans-Tasman Radiation Oncology Group 96.01 randomised cont rolled trial. Lancet Oncol 2005; 6(11):841−50.25. Bolla M., de Reijke T.M., Van Tienhoven GEORTC Radiation Oncology Group and Genito-Urinary Tract Cancer Group. Duration of androgen suppression in the treatment of prostate cancer. N Engl J Med 2009;360(24):2516−27.Bolla M., de Reijke T.M., Van Tienhoven GEORTC Radiation Oncology Group and Genito-Urinary Tract Cancer Group. Duration of androgen suppression in the treatment of prostate cancer. N Engl J Med 2009;360(24):2516−27.