H high-risk localized or locally advanced Gefitinib Iressa prostate cancer who undergo primary to Re external beam RT. However, this decision must be weighed against the long-known long-term toxicity Th of ADT, are mainly among people with known risk factors for metabolic syndrome, cardiovascular disease and osteoporosis. ADT, ADT alone alone use for M Men with clinically localized prostate cancer want to avoid surgery or primary Re RT is usually not recommended because of concerns for a negative influence on the outcome of prostate cancer and quality of life T with this approach.14 In an analysis of 19 271 M nnern with prostate cancer in the Surveillance, Epidemiology and End Results database primary associated with Medicare, the use re ADT was obtained with a Hten risk of prostate cancer-specific mortality t compared coupled with the observation: 1.03 1.33, and there was no difference in overall survival mortality.39 As s’ was an observational study, it is quite possible m that these results were due to confusion with the code. In a randomized Phase III, not the M Men early ADT vs. galvanized siege, Not a radical prostatectomy were subjected not initially seem out of the concept Highest profit. After a median follow-up of 9.6 years, 62.9% had died, including 76% of prostate cancer. For those randomized to early or late Teren ADT, the HR for survival in the immediate and deferred amounted to 1.23 in comparison, indicating a trend to 23% with no significant benefit of early treatment.40 For M Men clinical T3 disease, definitive therapy with radical prostatectomy or primary Ren or ADT with RT approach is generally recommended. The final advantage of RT w While ADT was alone in a randomized study in which patients with the disease at high risk for ADT vs. ADT plus RT alone.41 The overall mortality T 10 years was lower in the RT arm, studied more ADT. Biochemical progression of biochemical recurrence of prostate cancer as a allm Hlich increasing PSA level after RT or primary Ren surgical treatment or both, in the absence of radiographic evidence of metastatic disease. The exact definition varies, depending on the primary Rtherapie Re abh Ngig U. For example, define, for M Men, radical prostatectomy, k Can biochemical progression by erh Increase in PSA or a PSA of 0.4 ng o0.2 ML21 or at least three consecutive reviews. 42 Whether the increase in PSA local recurrence or reflected away from the disease is difficult to assess, although the latter is more likely, with h Higher PSA levels. In a retrospective study of a big series of surgical de M Nnern in a single institution undergoing radical prostatectomy for clinically localized prostate cancer, developed 315 M Men biochemical PSA failure. Among those who do not U have again starting ADT, 34% developed metastatic disease with a median time to metastases of 8 years from the date of PSA relapse. Au addition in this study, factors that predicted the risk of disease developingmetastatic identified To go Ren time to biochemical progression, doubling Gleason score and PSA time.43 an updated VX-770 analysis of this cohort with an l ngeren determined follow-up to the median survival time without metastases at M nnern biochemically recurrent prostate cancer after radical prostatectomy was 10 years, save in the absence of radiation or hormonal therapies.44 agrees on this time engaged metast.