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Local Salvage Therapy Alone for Local Recurrence of Prostate Cancer After Radiotherapy: A Systematic Review and

Marcin Miszczyk1,2, Federico Mastroleo3,4, Anna Kujawska5

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JAMA Oncology
|April 30, 2026
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Summary

Local therapies offer effective treatment for radiorecurrent prostate cancer (PCa) without systemic therapy. Androgen-deprivation therapy-free survival remains high at 5 years, with manageable adverse events for select patients.

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Area of Science:

  • Urology
  • Oncology
  • Radiotherapy

Background:

  • Standard management for radiorecurrent prostate cancer (PCa) involves systemic therapy, often androgen-deprivation therapy (ADT).
  • Some patients prefer to avoid ADT due to potential adverse events (AEs).

Conclusions:

  • Local therapies alone demonstrate reasonable efficacy for well-selected patients with radiorecurrent PCa.
  • ADT-FS is maintained for over half of patients at 5 years, with a low rate of early metastasis.
  • Salvage HDR-BT, HIFU, SBRT, and cryotherapy offer manageable severe toxicity profiles.