Biological synergy

  • Hormone therapy shrinks gland/tumor volume, reducing hypoxia and improving dose conformity.

  • Cell-cycle arrest in G1 enhances radiosensitivity.

  • Micro-environmental effect: decreased VEGF → better perfusion → higher O₂ → ↑ radiation kill.

Clinical evidence

Trial Population Key finding
RTOG 8610 / EORTC 22961 Locally advanced prostate ADT + RT ↑ OS ~20 % vs RT alone
TROG 96.01 Locally advanced prostate 3–6 mo neoadj ADT ↓ biochemical failure
EBCTCG Meta-analysis ER+ breast Endocrine therapy + RT ↓ local recurrence ~ 50 %

Practical integration

Cancer Sequence Duration
Prostate Start ADT 2–3 mo before RT → continue during + 18–36 mo after Long-term for high-risk
Breast RT usually after chemo; endocrine can start concurrently or ≤ 3 weeks post-RT 5–10 y total endocrine

(NCCN Prostate 2025; ESMO Breast 2024)

PreviousNext