Adjuvant and salvage radiotherapy after prostatectomy: AUA/ASTRO guideline

Ian M. Thompson, Richard K. Valicenti, Peter Albertsen, Brian J. Davis, S. Larry Goldenberg, Carol Hahn, Eric Klein, Jeff Michalski, Mack Roach, Oliver Sartor, J. Stuart Wolf, Martha M. Faraday

Research output: Contribution to journalArticle

242 Citations (Scopus)

Abstract

Purpose: The purpose of this guideline is to provide a clinical framework for the use of radiotherapy after radical prostatectomy as adjuvant or salvage therapy. Materials and Methods: A systematic literature review using the PubMed®, Embase, and Cochrane databases was conducted to identify peer-reviewed publications relevant to the use of radiotherapy after prostatectomy. The review yielded 294 articles; these publications were used to create the evidence-based guideline statements. Additional guidance is provided as Clinical Principles when insufficient evidence existed. Results: Guideline statements are provided for patient counseling, the use of radiotherapy in the adjuvant and salvage contexts, defining biochemical recurrence, and conducting a re-staging evaluation. Conclusions: Physicians should offer adjuvant radiotherapy to patients with adverse pathologic findings at prostatectomy (i.e., seminal vesicle invasion, positive surgical margins, extraprostatic extension) and should offer salvage radiotherapy to patients with prostatic specific antigen or local recurrence after prostatectomy in whom there is no evidence of distant metastatic disease. The offer of radiotherapy should be made in the context of a thoughtful discussion of possible short- and long-term side effects of radiotherapy as well as the potential benefits of preventing recurrence. The decision to administer radiotherapy should be made by the patient and the multi-disciplinary treatment team with full consideration of the patient's history, values, preferences, quality of life, and functional status. Please visit the ASTRO and AUA websites (http://www.redjournal.org/webfiles/ images/journals/rob/RAP%20Guideline.pdf and http://www.auanet.org/education/ guidelines/radiation-after-prostatectomy.cfm) to view this guideline in its entirety, including the full literature review.

Original languageEnglish (US)
Pages (from-to)441-449
Number of pages9
JournalJournal of Urology
Volume190
Issue number2
DOIs
StatePublished - Aug 2013
Externally publishedYes

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Adjuvant Radiotherapy
Prostatectomy
Radiotherapy
Guidelines
Recurrence
Publications
Salvage Therapy
Seminal Vesicles
PubMed
Counseling
Quality of Life
Databases
Radiation
Physicians
Education
Antigens

Keywords

  • postoperative period
  • prostatectomy
  • prostatic neoplasms
  • radiotherapy

ASJC Scopus subject areas

  • Urology

Cite this

Thompson, I. M., Valicenti, R. K., Albertsen, P., Davis, B. J., Goldenberg, S. L., Hahn, C., ... Faraday, M. M. (2013). Adjuvant and salvage radiotherapy after prostatectomy: AUA/ASTRO guideline. Journal of Urology, 190(2), 441-449. https://doi.org/10.1016/j.juro.2013.05.032

Adjuvant and salvage radiotherapy after prostatectomy : AUA/ASTRO guideline. / Thompson, Ian M.; Valicenti, Richard K.; Albertsen, Peter; Davis, Brian J.; Goldenberg, S. Larry; Hahn, Carol; Klein, Eric; Michalski, Jeff; Roach, Mack; Sartor, Oliver; Wolf, J. Stuart; Faraday, Martha M.

In: Journal of Urology, Vol. 190, No. 2, 08.2013, p. 441-449.

Research output: Contribution to journalArticle

Thompson, IM, Valicenti, RK, Albertsen, P, Davis, BJ, Goldenberg, SL, Hahn, C, Klein, E, Michalski, J, Roach, M, Sartor, O, Wolf, JS & Faraday, MM 2013, 'Adjuvant and salvage radiotherapy after prostatectomy: AUA/ASTRO guideline', Journal of Urology, vol. 190, no. 2, pp. 441-449. https://doi.org/10.1016/j.juro.2013.05.032
Thompson IM, Valicenti RK, Albertsen P, Davis BJ, Goldenberg SL, Hahn C et al. Adjuvant and salvage radiotherapy after prostatectomy: AUA/ASTRO guideline. Journal of Urology. 2013 Aug;190(2):441-449. https://doi.org/10.1016/j.juro.2013.05.032
Thompson, Ian M. ; Valicenti, Richard K. ; Albertsen, Peter ; Davis, Brian J. ; Goldenberg, S. Larry ; Hahn, Carol ; Klein, Eric ; Michalski, Jeff ; Roach, Mack ; Sartor, Oliver ; Wolf, J. Stuart ; Faraday, Martha M. / Adjuvant and salvage radiotherapy after prostatectomy : AUA/ASTRO guideline. In: Journal of Urology. 2013 ; Vol. 190, No. 2. pp. 441-449.
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abstract = "Purpose: The purpose of this guideline is to provide a clinical framework for the use of radiotherapy after radical prostatectomy as adjuvant or salvage therapy. Materials and Methods: A systematic literature review using the PubMed{\circledR}, Embase, and Cochrane databases was conducted to identify peer-reviewed publications relevant to the use of radiotherapy after prostatectomy. The review yielded 294 articles; these publications were used to create the evidence-based guideline statements. Additional guidance is provided as Clinical Principles when insufficient evidence existed. Results: Guideline statements are provided for patient counseling, the use of radiotherapy in the adjuvant and salvage contexts, defining biochemical recurrence, and conducting a re-staging evaluation. Conclusions: Physicians should offer adjuvant radiotherapy to patients with adverse pathologic findings at prostatectomy (i.e., seminal vesicle invasion, positive surgical margins, extraprostatic extension) and should offer salvage radiotherapy to patients with prostatic specific antigen or local recurrence after prostatectomy in whom there is no evidence of distant metastatic disease. The offer of radiotherapy should be made in the context of a thoughtful discussion of possible short- and long-term side effects of radiotherapy as well as the potential benefits of preventing recurrence. The decision to administer radiotherapy should be made by the patient and the multi-disciplinary treatment team with full consideration of the patient's history, values, preferences, quality of life, and functional status. Please visit the ASTRO and AUA websites (http://www.redjournal.org/webfiles/ images/journals/rob/RAP{\%}20Guideline.pdf and http://www.auanet.org/education/ guidelines/radiation-after-prostatectomy.cfm) to view this guideline in its entirety, including the full literature review.",
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