A Prospective Study to Assess the Impact of Neoadjuvant Androgen Deprivation Therapy on Tumor Volume, Rectal and Bladder Doses with Image Guided Radiation Therapy in Locally Advanced Prostate Cancer

Background & Objective: Prostate cancer has ranked among top ten leading sites of cancer. aim to compare the prostate size, rectal and bladder doses at specified volumes before initiating NAHT and after NAHT, just before starting radiotherapy. We want to assess, if NAHT decreases the dose to bladder and rectum by shrinking prostate, thus reducing treatment related toxicity, & thereby increasing the patient compliance. Methods: This is Observational an Prospective study. Results: In the present study, 23.4% (Pless than0.001%) reduction was seen in target volume after 3-4 months of NAHT. Our study, had 19 patients (51.4%) from intermediate risk group while 8 patients were from high risk group (48.6%). The mean prostate volume before NHT was 62.5? 22.1 cm3. Mean Sr. PSA levels reduction was 38.6% with the use of NAHT. The mean Dmax of rectum in current study, before and after NAHT was 47.93+22.82Gy and 47.81+22.83Gy, the average Dmean before and after NAHT was 65.57+21.38Gy and 65+21.42Gy. Both had significant reduction in values of 0.11 & 0.21. Average Dmean of bladder, in our study before and after NAHT is 51.32+17.24Gy and 50.99+17.18 Gy; average Dmax before and after were 65.57+21.38Gy & 65+21.42Gywhich showed an non-significant decrease of 0.33 & 0.44 respectively. Conclusion: the present study demonstrated that neoadjuvant hormonal therapy of minimum 3 months duration decreased the prostate volume and Sr. PSA.