Adjuvant and Salvage Radiation Therapy After Prostatectomy Guideline

  • 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

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    ASTRO guidelines present scientific, health, and safety information and may reflect scientific or medical opinion. They are available to ASTRO members and the public for educational and informational purposes only. Commercial use of any content in this guideline without the prior written consent of ASTRO is strictly prohibited.