Abstract
Adverse pathologic features - including positive surgical margins, extracapsular extension, and seminal vesicle invasion - are common findings at radical prostatectomy for clinically localised disease. In the absence of further treatment, patients with such features are at high risk of biochemical and local recurrence and the development of metastatic disease. Radiotherapy is the only known curative treatment modality in patients with locally recurrent disease. Its optimal use following surgery, however, is controversial. In this review, the evidence for immediate (adjuvant) and selective early salvage approaches to postoperative radiotherapy are presented. The results of three randomized controlled trials comparing adjuvant radiotherapy to observation are discussed. The trial with the longest follow-up now demonstrates that, compared to a policy of observation, adjuvant radiotherapy prolongs overall survival and prevents distant metastases. It is not clear, however, whether this survival advantage would remain if adjuvant radiotherapy were compared to a strategy of close monitoring with salvage radiotherapy instituted at the time of biochemical failure. A selective salvage strategy has the advantage of avoiding ‘unnecessary’ radiotherapy, and its toxicity, for those patients destined not to fail after surgery. Large-scale randomized controlled trials comparing these two approaches are underway.
Keywords: Prostate cancer, radiotherapy, radical prostatectomy, adjuvant therapy, salvage therapy
Current Cancer Therapy Reviews
Title: Postoperative Radiotherapy After Radical Prostatectomy: Adjuvant or Salvage?
Volume: 7 Issue: 3
Author(s): Scott C. Morgan and Chris C. Parker
Affiliation:
Keywords: Prostate cancer, radiotherapy, radical prostatectomy, adjuvant therapy, salvage therapy
Abstract: Adverse pathologic features - including positive surgical margins, extracapsular extension, and seminal vesicle invasion - are common findings at radical prostatectomy for clinically localised disease. In the absence of further treatment, patients with such features are at high risk of biochemical and local recurrence and the development of metastatic disease. Radiotherapy is the only known curative treatment modality in patients with locally recurrent disease. Its optimal use following surgery, however, is controversial. In this review, the evidence for immediate (adjuvant) and selective early salvage approaches to postoperative radiotherapy are presented. The results of three randomized controlled trials comparing adjuvant radiotherapy to observation are discussed. The trial with the longest follow-up now demonstrates that, compared to a policy of observation, adjuvant radiotherapy prolongs overall survival and prevents distant metastases. It is not clear, however, whether this survival advantage would remain if adjuvant radiotherapy were compared to a strategy of close monitoring with salvage radiotherapy instituted at the time of biochemical failure. A selective salvage strategy has the advantage of avoiding ‘unnecessary’ radiotherapy, and its toxicity, for those patients destined not to fail after surgery. Large-scale randomized controlled trials comparing these two approaches are underway.
Export Options
About this article
Cite this article as:
C. Morgan Scott and C. Parker Chris, Postoperative Radiotherapy After Radical Prostatectomy: Adjuvant or Salvage?, Current Cancer Therapy Reviews 2011; 7 (3) . https://dx.doi.org/10.2174/157339411796234898
DOI https://dx.doi.org/10.2174/157339411796234898 |
Print ISSN 1573-3947 |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-6301 |
Call for Papers in Thematic Issues
Current progress in Protein Degradation and Cancer Therapy
argeted Protein Degradation is gaining momentum in cancer therapy, it facilitate targeting undruggable proteins, it overcome cancer resistance and avoid undesirable side effects. Thus small molecules degraders have emerged as novel therapeutic strategy. Targeted protein degradation (TPD), the process of eliminating a protein of interest hold a great promise for ...read more
- Author Guidelines
- Graphical Abstracts
- Fabricating and Stating False Information
- Research Misconduct
- Post Publication Discussions and Corrections
- Publishing Ethics and Rectitude
- Increase Visibility of Your Article
- Archiving Policies
- Peer Review Workflow
- Order Your Article Before Print
- Promote Your Article
- Manuscript Transfer Facility
- Editorial Policies
- Allegations from Whistleblowers
Related Articles
-
Evaluating the Effect of Integra Seeded with Adipose Tissue-Derived Stem Cells or Fibroblasts in Wound Healing
Current Drug Delivery Integrins: A Method of Early Intervention in the Treatment of Colorectal Liver Metastases
Current Pharmaceutical Design Use of Anti-Cancer Drugs, Mitocans, to Enhance the Immune Responses against Tumors
Current Pharmaceutical Biotechnology Do Not Say Ever Never More: The Ins and Outs of Antiangiogenic Therapies
Current Pharmaceutical Design Synthesis and Urease Inhibitory Activity of Some 5-Aminomethylene Barbituric/Thiobarbituric Acid Derivatives
Letters in Drug Design & Discovery Is the Modulation of Autophagy the Future in the Treatment of Neurodegenerative Diseases?
Current Topics in Medicinal Chemistry Understanding and Applying Personalized Therapeutics at Systems Level:Role for Translational Bioinformatics
Current Pharmacogenomics and Personalized Medicine Surgical Treatment of Endometriosis
Current Women`s Health Reviews Nanovehicle-based Small Interfering RNA (siRNA) Delivery for Therapeutic Purposes: A New Molecular Approach in Pharmacogenomics
Current Clinical Pharmacology Targeting Indoleamine 2,3-dioxygenase (IDO) to Counteract Tumour- Induced ImmuneDysfunction: From Biochemistry to Clinical Development
Endocrine, Metabolic & Immune Disorders - Drug Targets The Efficacy of Caelyx and Hyperthermia for Anticancer Treatment
Recent Patents on Anti-Cancer Drug Discovery Signal Transduction Inhibitors in the Treatment of Breast Cancer
Current Medicinal Chemistry - Anti-Cancer Agents TNF-α/Cycloheximide-Induced Oxidative Stress and Apoptosis in Murine Intestinal Epithelial MODE-K Cells
Current Pharmaceutical Design A Review on Phytochemistry and Pharmacology of Medicinal as well as Poisonous Mushrooms
Mini-Reviews in Medicinal Chemistry Editorial ( Thematic Issue: Diabetes and Cancer - Disease, Drugs or Deception?)
Current Drug Safety Targeting Basal-Like Breast Cancers
Current Drug Targets Autoantibody Profiles as Biomarkers for Response to Therapy and Early Detection of Cancer
Current Cancer Therapy Reviews Synthesis and Anticancer Evaluation of some Newer 2, 5-Disubstituted-1,3, 4-Oxadiazole Analogues
Letters in Drug Design & Discovery Epigenetic Modulation Using Small Molecules - Targeting Histone Acetyltransferases in Disease
Current Medicinal Chemistry Enkephalin-Fentanyl Multifunctional Opioids as Potential Neuroprotectants for Ischemic Stroke Treatment
Current Pharmaceutical Design