Related Experiment Video
Updated: May 2, 2026
08:34
Proton Therapy Delivery and Its Clinical Application in Select Solid Tumor Malignancies
Published on: February 6, 2019
20.1K
Salvage Radiotherapy Following Nonradiotherapy Ablative Techniques for Primary Prostate Cancer: A Systematic Review
Osama Mohamad1, Lucas Mose2, Maiwand Ahmadsei3
1Department of Genitourinary Radiation Oncology, MD Anderson Cancer Center, Houston, TX, USA.
European Urology Focus
|April 12, 2025
Summary
Salvage radiotherapy (SRT) after nonradiotherapy ablative interventions (NRAIs) for prostate cancer shows low toxicity, especially after cryotherapy, with similar efficacy for high-intensity focused ultrasound (HIFU) and cryotherapy. Further studies are needed for long-term outcomes.
Area of Science:
- Oncology
- Radiation Oncology
- Urology
Background:
- Nonradiotherapy ablative interventions (NRAIs) like HIFU and cryotherapy are increasingly used for localized prostate cancer.
- These treatments carry a risk of recurrence, necessitating salvage therapies.
- The safety and efficacy of salvage radiotherapy (SRT) after NRAIs are not well-established.
Purpose of the Study:
- To systematically review and meta-analyze the safety and efficacy of SRT in patients with recurrent prostate cancer after NRAI.
- To assess SRT safety regarding acute and late gastrointestinal (GI) and genitourinary (GU) toxicities.
- To evaluate SRT efficacy based on biochemical relapse rates after different NRAIs (HIFU vs. cryotherapy).
Main Methods:
- A comprehensive literature search was performed across major databases (PubMed, Web of Science, Scopus, Cochrane Library) up to August 2023.
- Included studies assessed SRT outcomes (toxicities, biochemical relapse) in patients with prostate cancer recurrence post-NRAI.
- Random-effects meta-analysis was used to pool data on toxicity and relapse rates, with heterogeneity and publication bias assessed.
Main Results:
- Twenty-one studies with 817 patients were analyzed.
- Pooled acute grade 1-2 GI and GU toxicities were 22% and 37%, respectively, higher after HIFU than cryotherapy.
- Late grade 1-2 GI and GU toxicities were 12% and 26%, respectively. Grade ≥3 toxicities were rare (<5%).
- Biochemical relapse rates were ~20% for both HIFU and cryotherapy, indicating similar efficacy.
Conclusions:
- SRT following NRAI for prostate cancer demonstrates low toxicity, particularly after cryotherapy, and provides reasonable biochemical control.
- Higher acute toxicities were observed following high-intensity focused ultrasound (HIFU) compared to cryotherapy.
- Further research is needed to refine SRT protocols and establish long-term outcomes due to short follow-up and treatment variability.
