Prostate cancer: more effective use of underutilized postoperative radiation therapy

Giovanni Motterle, Alessandro Morlacco, Fabio Zattoni, R. Jeffrey Karnes

Research output: Contribution to journalReview articlepeer-review

Abstract

Introduction: Adverse pathological features at radical prostatectomy such as extracapsular extension, seminal-vesicle involvement, positive surgical margins and/or lymph node invasion define a particular subgroup of patients that might benefit from additional treatment after surgery, in particular radiation therapy. Areas covered: Post-prostatectomy radiation is intended as adjuvant, early-salvage or salvage depending on the timing and PSA levels at the treatment. After providing the most used definitions, the high-level evidence supporting adjuvant radiation is reviewed together with the limitations affecting its utilization. In recent years early-salvage radiation was hypothesized to be a non-inferior alternative based on good-quality retrospective data. Recently, preliminary results of ongoing trials provide additional evidence. In light of the need to identify patients that will truly benefit from adjuvant radiation, clinically based and molecular tools available for this purpose are reviewed. Expert opinion: In order to tailor treatment for the patient after radical prostatectomy, there is a need for a tool that could both improve the oncological outcomes and be cost-effective. To date, genomic testing provides the most promising results that will be reasonably improved in the coming years.

Original languageEnglish (US)
JournalExpert review of anticancer therapy
DOIs
StateAccepted/In press - Jan 1 2020

Keywords

  • Adjuvant Radiation Therapy
  • biochemical recurrence
  • early salvage radiation therapy
  • prostate cancer
  • radical prostatectomy

ASJC Scopus subject areas

  • Oncology
  • Pharmacology (medical)

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