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Improving postoperative radiotherapy following radical prostatectomy.
D Lipman1, B R Pieters1, Theo M De Reijke2
1a Department of Radiation Oncology , Academic Medical Center/University of Amsterdam , Amsterdam , The Netherlands.
Expert Review of Anticancer Therapy
|August 9, 2017
Summary
Postoperative radiotherapy after prostatectomy can benefit patients with rising PSA levels. This approach helps select suitable candidates, avoiding unnecessary treatment and toxicity for others, while improving outcomes for those with recurrent prostate cancer.
Area of Science:
- Oncology
- Radiotherapy
- Urology
Background:
- Prostate cancer is a high-incidence malignancy with curative options like radical prostatectomy and radiotherapy.
- Approximately 30% of patients experience recurrence after initial curative treatment, necessitating adjuvant therapy.
- The optimal selection of patients for postoperative radiotherapy remains a subject of debate.
Purpose of the Study:
- To review the literature on postoperative radiotherapy following radical prostatectomy.
- To emphasize the findings of five randomized trials in this area.
- To discuss advancements in patient selection for adjuvant radiotherapy.
Main Methods:
- Review of available literature on postoperative radiotherapy after radical prostatectomy.
- Emphasis on five key randomized trials.
- Discussion of novel imaging (PSMA-PET, mp-MRI) and biomarkers (genomic classifiers).
Main Results:
- Evidence from five randomized trials informs the debate on adjuvant radiotherapy.
- New imaging and biomarkers show promise for improved patient selection.
- Advanced radiotherapy techniques can minimize toxicity.
Conclusions:
- Patients with biochemical recurrence and rising PSA post-prostatectomy are most likely to benefit from adjuvant radiotherapy.
- Improved patient selection can prevent overtreatment and toxicity in high-risk cases.
- Early intervention for progressing patients ensures favorable outcomes.
