Radiotherapy following radical prostatectomy

Abstract

Radiotherapy following radical prostatectomy has been controversial and no consensus has developed on the most appropriate use of radiotherapy after radical prostatectomy. In the last decade the results of three randomized controlled trials examining the effects of early radiotherapy after radical prostatectomy in patients with high-risk features (positive surgical margins, extracapsular extension and seminal vesical involvement) have been published. The results of these trials indicate that early radiotherapy changes the natural history of high-risk prostate cancer. Specifically, early radiotherapy reduces the risk of biochemical recurrence, improves clinical disease-free survival, decreases the utilization of salvage androgen suppression and, in the study with longest follow-up, early radiotherapy improves overall survival. This article will review the evidence, provide a commentary on the existing evidence, and describe key issues going forward (timing of radiotherapy, androgen suppression and radiotherapy techniques).

Keywords::

• adjuvant radiotherapy
• androgen deprivation therapy
• radical prostatectomy
• salvage radiotherapy

Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.