TY  - JOUR
A1  - Zattoni, Fabio
A1  - Heidegger, Isabel
A1  - Kasivisvanathan, Veeru
A1  - Kretschmer, Alexander
A1  - Marra, Giancarlo
A1  - Magli, Alessandro
A1  - Preißer, Felix Martin
A1  - Tilki, Derya
A1  - Tsaur, Igor
A1  - Valerio, Massimo
A1  - Bergh, Roderick van den
A1  - Kesch, Claudia
A1  - Ceci, Francesco
A1  - Fankhauser, Christian D.
A1  - Gandaglia, Giorgio
T1  - Radiation therapy after radical prostatectomy: what has changed over time?
T2  - Frontiers in Surgery
N2  - 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.
KW  - prostate cancer
KW  - adjuvant radiotherapy
KW  - salvage radiotherapy
KW  - biochemical recurrence
KW  - hormonal therapy
KW  - genomic classifiers
Y1  - 2021
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/62040
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-620407
SN  - 2296-875X
VL  - 8.2021
IS  - art. 691473
SP  - 1
EP  - 10
PB  - Frontiers Media
CY  - Lausanne
ER  -