Table 1 summarizes findings from the studies on tri-modality therapy for locally advanced PCa. Subsequent treatment after the biochemical failure of external beam radiation therapy combined with hormonal therapy may be associated with equivalent overall survival rates in the two modality groups. Regarding hormonal therapy, previous reports showed that high-dose external beam radiation therapy combined with hormonal therapy decreased PSA biochemical recurrence and improved the overall survival of patients with locally advanced or recurrent PCa [30,31]. This evidence concerns the gene KLK3 and posterior cortical atrophy.