ASTRO's guideline on adjuvant and salvage RT after prostatectomy

Publication
Print – August 2013

This collaborative guideline developed recommendations on several questions related to appropriate use of radiation therapy in patients who have undergone prostatectomy, both as adjuvant therapy following surgery and after recurrence. It examines the impact of adjuvant RT on recurrence and survival and how these outcomes are affected by factors such as margin status, seminal vesicle invasion, Gleason score and patient age. For salvage therapy, the guideline also addresses whether RT improves outcomes and whether its effects are limited to certain patient subgroups. In addition, the document considers the question of whether to administer adjuvant RT prior to recurrence or wait and treat patients who recur with salvage RT. Finally, radiation therapy techniques, use of androgen deprivation therapy together with RT and data on toxicity and quality of life in the post-prostatectomy setting are discussed.

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Quick Reference

• Counseling patients concerning risks of cancer recurrence after radical prostatectomy and benefits and risks of adjuvant radiotherapy (ART)
• Offering patients ART after prostatectomy
• Monitoring prostatic specific antigen (PSA) levels after prostatectomy to detect recurrence
• Restaging evaluation in patients with a PSA recurrence
• Offering salvage radiotherapy (SRT) to patients with PSA or local recurrence
• Informing patients about effectiveness of radiotherapy for PSA recurrence
• Informing patients about benefits and short- and long-term side effects of SFT for controlling disease recurrence

Resources
Challenging Cases in the Management of Newly Diagnosed and Recurrent Prostate Cancer

Author Society
American Society for Radiation Oncology
American Urological Association

Previous version
None

Endorsements
American Society of Clinical Oncology