Salvage Versus Adjuvant Radiation Therapy Following Radical Prostatectomy in Localised Prostate Cancer: A War Without a Winner

ObjectiveTo review current literature regarding the efficacy of adjuvant radiation therapy (ART) and salvage radiation therapy (SRT) following radical prostatectomy (RP) in patients with undetectable postoperative prostate-specific antigen (PSA) levels and high-risk features of prostate cancer (PCa)...

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Main Authors: Lara Rodriguez-Sanchez, Petr Macek, Camille Lanz, Qusay Mandoorah, Nuno Dias, Gianmarco Colandrea, Fernando P. Secin, Amandeep M. Arora, Rafael Sanchez-Salas, Xavier Cathelineau
Format: Article
Language:English
Published: MDPI AG 2023-01-01
Series:Société Internationale d’Urologie Journal
Subjects:
Online Access:https://siuj.org/index.php/siuj/article/view/236/183
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author Lara Rodriguez-Sanchez
Petr Macek
Camille Lanz
Qusay Mandoorah
Nuno Dias
Gianmarco Colandrea
Fernando P. Secin
Amandeep M. Arora
Rafael Sanchez-Salas
Xavier Cathelineau
author_facet Lara Rodriguez-Sanchez
Petr Macek
Camille Lanz
Qusay Mandoorah
Nuno Dias
Gianmarco Colandrea
Fernando P. Secin
Amandeep M. Arora
Rafael Sanchez-Salas
Xavier Cathelineau
author_sort Lara Rodriguez-Sanchez
collection DOAJ
description ObjectiveTo review current literature regarding the efficacy of adjuvant radiation therapy (ART) and salvage radiation therapy (SRT) following radical prostatectomy (RP) in patients with undetectable postoperative prostate-specific antigen (PSA) levels and high-risk features of prostate cancer (PCa) recurrence. MethodsSeven randomized controlled trials focused on the use of ART compared with either observation or SRT after RP that had been published in PubMed up to May 2022 were reviewed. ResultsThe use of ART following RP has been the treatment of choice over the past decade. Three RCTs comparing ART with early SRT show that SRT given as soon as biochemical recurrence (BCR) is detected is not inferior to ART while it offers the opportunity to avoid overtreatment and potential RT-related side effects. A meta-analysis summarizing the results from these trials supports these findings. ConclusionsEarly SRT may be suggested as the standard of care for patients with PCa and high-risk features for disease recurrence following RP. Nevertheless, further investigations are needed to identify those patients who will benefit from ART, particularly, in case of lymph node involvement. Moreover, some patients might avoid SRT despite reaching detectable postoperative serum PSA levels
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spelling doaj.art-d49ea77930c54547bb7b0ef892f1295b2024-04-03T10:09:11ZengMDPI AGSociété Internationale d’Urologie Journal2563-64992023-01-0141405010.48083/MSVK1934Salvage Versus Adjuvant Radiation Therapy Following Radical Prostatectomy in Localised Prostate Cancer: A War Without a WinnerLara Rodriguez-SanchezPetr MacekCamille LanzQusay MandoorahNuno DiasGianmarco ColandreaFernando P. SecinAmandeep M. AroraRafael Sanchez-Salas Xavier Cathelineau ObjectiveTo review current literature regarding the efficacy of adjuvant radiation therapy (ART) and salvage radiation therapy (SRT) following radical prostatectomy (RP) in patients with undetectable postoperative prostate-specific antigen (PSA) levels and high-risk features of prostate cancer (PCa) recurrence. MethodsSeven randomized controlled trials focused on the use of ART compared with either observation or SRT after RP that had been published in PubMed up to May 2022 were reviewed. ResultsThe use of ART following RP has been the treatment of choice over the past decade. Three RCTs comparing ART with early SRT show that SRT given as soon as biochemical recurrence (BCR) is detected is not inferior to ART while it offers the opportunity to avoid overtreatment and potential RT-related side effects. A meta-analysis summarizing the results from these trials supports these findings. ConclusionsEarly SRT may be suggested as the standard of care for patients with PCa and high-risk features for disease recurrence following RP. Nevertheless, further investigations are needed to identify those patients who will benefit from ART, particularly, in case of lymph node involvement. Moreover, some patients might avoid SRT despite reaching detectable postoperative serum PSA levelshttps://siuj.org/index.php/siuj/article/view/236/183prostatic neoplasmsprostatectomyrisk factorsadjuvant radiotherapysalvage therapy
spellingShingle Lara Rodriguez-Sanchez
Petr Macek
Camille Lanz
Qusay Mandoorah
Nuno Dias
Gianmarco Colandrea
Fernando P. Secin
Amandeep M. Arora
Rafael Sanchez-Salas
Xavier Cathelineau
Salvage Versus Adjuvant Radiation Therapy Following Radical Prostatectomy in Localised Prostate Cancer: A War Without a Winner
Société Internationale d’Urologie Journal
prostatic neoplasms
prostatectomy
risk factors
adjuvant radiotherapy
salvage therapy
title Salvage Versus Adjuvant Radiation Therapy Following Radical Prostatectomy in Localised Prostate Cancer: A War Without a Winner
title_full Salvage Versus Adjuvant Radiation Therapy Following Radical Prostatectomy in Localised Prostate Cancer: A War Without a Winner
title_fullStr Salvage Versus Adjuvant Radiation Therapy Following Radical Prostatectomy in Localised Prostate Cancer: A War Without a Winner
title_full_unstemmed Salvage Versus Adjuvant Radiation Therapy Following Radical Prostatectomy in Localised Prostate Cancer: A War Without a Winner
title_short Salvage Versus Adjuvant Radiation Therapy Following Radical Prostatectomy in Localised Prostate Cancer: A War Without a Winner
title_sort salvage versus adjuvant radiation therapy following radical prostatectomy in localised prostate cancer a war without a winner
topic prostatic neoplasms
prostatectomy
risk factors
adjuvant radiotherapy
salvage therapy
url https://siuj.org/index.php/siuj/article/view/236/183
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