**1. Introduction**

194 Prostate Cancer – Diagnostic and Therapeutic Advances

Yoshioka, Y., Konishi, K., Oh, R-J. et al. (2006). High-dose-rate brachytherapy without

*Oncology*, vol. 80, pp. (62-68)

external beam irradiation for locally advanced prostate cancer. *Radiotherapy and* 

There are around 35,000 new cases of prostate carcinoma (PCa) in the UK per annum, making it the most common solid malignancy. Approximately 10,000 men die of PCa each year in the UK (http://infocancerresearchukorg/cancerstats/). Disease incidence is increasing partly due to earlier detection and the increasing age of the population. Environmental causes especially dietary factors have been postulated but this is still an area of research. At presentation ~60% of patients have localised, ~30% locally advanced and 10% metastatic disease.

Radical radiotherapy (RT) can be used as part of curative therapy for both localised and locally advanced disease but has no proven role in the metastatic setting. Recently, radiation has been shown to cause immunogenic tumour cell death and to modify immunosuppression in the tumour environment. Importantly, reduction of tumour burden by RT, in an ablative setting, has been shown to depend largely on T cell responses (Lee et al., 2009). Combination of ionising radiation (IR) and immunological approaches in preclinical models of PCa has also proved to be synergistic. Immunotherapy offers a unique cotreatment that enables the patients' own immune cells to contribute to the success of RT. Immunological memory, developing as the result of the combination treatment, may provide long-term protection from tumour recurrence. There are however very few clinical trials addressing how immunotherapy and RT can be best combined for clinical efficiency.
