In the past year or so, at least 4 papers have appeared which suggest
that use of short-term HT with RT (Brachy, HDR, XBRT) provides no
benefit and may even be counterproductive in some cases.  In addition
to the apparent lack of therapeutic advantage, HT adversely impacts QOL
and adds cost...Best wishes and good health, Ron

Int J Radiat Oncol Biol Phys. 2004 Mar 15;58(4):1048-55
Long-term outcome by risk factors using conformal high-dose-rate
brachytherapy (HDR-BT) boost with or without neoadjuvant androgen
suppression for localized prostate cancer.
Galalae RM, Martinez A, Mate T, Mitchell C, Edmundson G, Nuernberg N,
Eulau S, Gustafson G, Gribble M, Kovacs G.
CONCLUSIONS: EBRT with HDR-BT produced excellent long-term outcomes in
terms of BC, DFS, and CSS in patients with prostate cancer even for
those at highest risk. Conformal HDR-BT is both a precise dose delivery
system and an effective treatment for both favorable and unfavorable
prostate cancer. The addition of a short course of
neoadjuvant/concurrent ADT failed to improve outcome. The results were
similar at all three institutions, giving credence to the
reproducibility of the brachytherapy treatment.

Int J Radiat Oncol Biol Phys. 2005 Apr 1;61(5):1299-305
Impact of short course hormonal therapy on overall and cancer specific
survival after permanent prostate brachytherapy
Beyer DC, McKeough T, Thomas T.
CONCLUSIONS: At 10 years, in prostate cancer patients receiving
brachytherapy, overall survival is worse in men receiving neoadjuvant
hormonal therapy, compared with hormone naive patients. This does not
appear to be due to other known risk factors for survival (i.e., stage,
grade, PSA, age) on multivariate analysis. The leading causes of death
were cardiovascular, prostate cancer, and other cancers with no obvious
discrepancy between the two groups. This finding is unexpected and
requires confirmation from other centers.

Int J Radiat Oncol Biol Phys. 2005 Aug 1;62(5):1309-15
Neoadjuvant hormone therapy and external-beam radiation for localized
high-risk prostate cancer: The importance of PSA nadir before
radiation.
Ludgate CM, Bishop DC, Pai H, Eldridge B, Lim J, Berthelet E, Blood P,
Piercy GB, Steinhoff G.
Conclusion Improved bDFS in patients with high-risk prostate cancer was
associated with lower initial PSA level, lower Gleason score, and lower
preradiation PSA level. The duration of NAHT did not have an impact on
outcomes, but the preradiation PSA was an important predictor of bDFS
in high-risk patients.

Int J Radiat Oncol Biol Phys. 2005 Aug 1;62(5):1322-31.
Lack of benefit from a short course of androgen deprivation for
unfavorable prostate cancer patients treated with an accelerated
hypofractionated regime.
Martinez AA, Demanes DJ, Galalae R, Vargas C, Bertermann H, Rodriguez
R, Gustafson G, Altieri G, Gonzalez J.
Conclusions: Accelerated hypofractionated pelvic EBRT integrated with
TRUS-guided conformally modulated HDR administered to 1,260 patients in
three institutions was an excellent method of delivering very high
radiation dose to the prostate in 5 weeks. Similar high overall,
cause-specific, and biochemical no evidence of disease survival rates
achieved show that prostate HDR can be successfully delivered in
academic and community settings. At 8 years, the addition of a course
of </=6 months of neoadjuvant/concurrent androgen deprivation therapy
to a very high radiation dose did not confer a therapeutic advantage
but added side effects and cost. Furthermore, for the most unfavorable
group, there was a higher rate of distant metastasis and more prostate
cancer-related deaths. We question the value of a short course of
androgen deprivation therapy when used with high-dose radiation.