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Postoperative Radiation After Radical Prostatectomy.

Eric C Ko1, Anthony L Michaud2, Richard K Valicenti2

  • 1Department of Radiation Oncology, University of California Davis School of Medicine, Sacramento, CA; Department of Radiation Oncology, Mercy UC Davis Cancer Center, Merced, CA.

Seminars in Radiation Oncology
|December 18, 2016
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Summary
This summary is machine-generated.

Adjuvant radiation therapy after prostatectomy benefits high-risk prostate cancer patients, improving survival and biochemical control. Ongoing research aims to refine patient selection for optimal outcomes and minimize side effects.

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Area of Science:

  • Oncology
  • Radiation Oncology
  • Urology

Background:

  • Three randomized trials show adjuvant radiation improves outcomes in high-risk prostate cancer post-prostatectomy.
  • One trial (SWOG 8794) demonstrated improved overall survival.
  • Clinical practice has evolved due to advanced PSA testing and recognizing patient heterogeneity.

Purpose of the Study:

  • Review evidence from published and ongoing trials on adjuvant radiation for prostate cancer.
  • Discuss current controversies and unanswered questions regarding postoperative radiation.
  • Explore strategies for improved patient selection using genomics and advanced imaging.

Main Methods:

  • Review of randomized clinical trials.
  • Analysis of published and ongoing trial data.
  • Discussion of current clinical controversies and emerging technologies.

Main Results:

  • Adjuvant radiation therapy significantly improves biochemical control after prostatectomy.
  • Overall survival benefits are demonstrated in select trials.
  • Patient selection remains a key challenge due to cohort heterogeneity.

Conclusions:

  • Adjuvant radiation offers significant benefits for high-risk prostate cancer patients.
  • Further research is needed to optimize timing and use of androgen-deprivation therapy.
  • Genomic tools and advanced imaging promise to enhance patient selection for postoperative radiation, minimizing toxicity.