Radiation Therapy After Radical Prostatectomy: What Has Changed Over Time?
Détails
Etat: Public
Version: Final published version
Licence: CC BY 4.0
ID Serval
serval:BIB_6ADAA0729F8F
Type
Article: article d'un périodique ou d'un magazine.
Sous-type
Synthèse (review): revue aussi complète que possible des connaissances sur un sujet, rédigée à partir de l'analyse exhaustive des travaux publiés.
Collection
Publications
Institution
Titre
Radiation Therapy After Radical Prostatectomy: What Has Changed Over Time?
Périodique
Frontiers in surgery
ISSN
2296-875X (Print)
ISSN-L
2296-875X
Statut éditorial
Publié
Date de publication
2021
Peer-reviewed
Oui
Volume
8
Pages
691473
Langue
anglais
Notes
Publication types: Journal Article ; Review
Publication Status: epublish
Publication Status: epublish
Résumé
The role and timing of radiotherapy (RT) in prostate cancer (PCa) patients treated with radical prostatectomy (RP) remains controversial. While recent trials support the oncological safety of early salvage RT (SRT) compared to adjuvant RT (ART) in selected patients, previous randomized studies demonstrated that ART might improve recurrence-free survival in patients at high risk for local recurrence based on adverse pathology. Although ART might improve survival, this approach is characterized by a risk of overtreatment in up to 40% of cases. SRT is defined as the administration of RT to the prostatic bed and to the surrounding tissues in the patient with PSA recurrence after surgery but no evidence of distant metastatic disease. The delivery of salvage therapies exclusively in men who experience biochemical recurrence (BCR) has the potential advantage of reducing the risk of side effects without theoretically compromising outcomes. However, how to select patients at risk of progression who are more likely to benefit from a more aggressive treatment after RP, the exact timing of RT after RP, and the use of hormone therapy and its duration at the time of RT are still open issues. Moreover, what the role of novel imaging techniques and genomic classifiers are in identifying the most optimal post-operative management of PCa patients treated with RP is yet to be clarified. This narrative review summarizes most relevant published data to guide a multidisciplinary team in selecting appropriate candidates for post-prostatectomy radiation therapy.
Mots-clé
adjuvant radiotherapy, biochemical recurrence, genomic classifiers, hormonal therapy, prostate cancer, salvage radiotherapy
Pubmed
Web of science
Open Access
Oui
Création de la notice
02/08/2021 14:55
Dernière modification de la notice
23/11/2022 8:11