Radiation therapy (RT) after prostatectomy: The case for salvage therapy as opposed to adjuvant therapy

Steven E. Schild

Research output: Contribution to journalArticle

29 Citations (Scopus)

Abstract

Patients with pathologic stage T3 or T4 prostate cancer who have undetectable PSA levels following radical retropubic prostatectomy (RRP) have a substantial risk of recurrence. Radiotherapy (RT) can be administered immediately following the RRP (immediate adjuvant RT) or may be postponed until the PSA level has risen to a level that is indicative of residual or recurrent prostate cancer (salvage RT). Immediate adjuvant RT can significantly reduce the risk of relapse, but does not appear to increase the rate of survival. Approximately two-thirds of patients with rising PSA levels after RRP can be salvaged with RT alone. This result was achieved in patients treated with an adequate dose of radiation before the PSA rose to > 1.1 ng/ml. While no one can be certain which approach (adjuvant or salvage RT) is better, future studies should examine this issue. Whether immediate postoperative adjuvant RT is of value to patients is the subject of two randomized prospective studies. The benefit of adjuvant RT is a matter of controversy. Salvage RT treats only those patients with proven residual prostate cancer. The salvage RT approach has several advantages. This approach spares approximately 40% of patients who have had an RRP for T3 or T4 prostate cancer and eliminates the risks and costs associated with adjuvant RT. Additionally, it appears that the results of immediate adjuvant RT are similar to those achieved with early salvage RT.

Original languageEnglish (US)
Pages (from-to)94-98
Number of pages5
JournalInternational Journal of Cancer
Volume96
Issue number2
DOIs
StatePublished - Apr 20 2001

Fingerprint

Salvage Therapy
Prostatectomy
Radiotherapy
Therapeutics
Prostatic Neoplasms
Recurrence
Residual Neoplasm
Secondary Prevention

Keywords

  • Adjuvant therapy
  • Prostate cancer
  • Radiation therapy
  • Salvage therapy

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Radiation therapy (RT) after prostatectomy : The case for salvage therapy as opposed to adjuvant therapy. / Schild, Steven E.

In: International Journal of Cancer, Vol. 96, No. 2, 20.04.2001, p. 94-98.

Research output: Contribution to journalArticle

@article{d41deef46f2246e495c206bb9d037dca,
title = "Radiation therapy (RT) after prostatectomy: The case for salvage therapy as opposed to adjuvant therapy",
abstract = "Patients with pathologic stage T3 or T4 prostate cancer who have undetectable PSA levels following radical retropubic prostatectomy (RRP) have a substantial risk of recurrence. Radiotherapy (RT) can be administered immediately following the RRP (immediate adjuvant RT) or may be postponed until the PSA level has risen to a level that is indicative of residual or recurrent prostate cancer (salvage RT). Immediate adjuvant RT can significantly reduce the risk of relapse, but does not appear to increase the rate of survival. Approximately two-thirds of patients with rising PSA levels after RRP can be salvaged with RT alone. This result was achieved in patients treated with an adequate dose of radiation before the PSA rose to > 1.1 ng/ml. While no one can be certain which approach (adjuvant or salvage RT) is better, future studies should examine this issue. Whether immediate postoperative adjuvant RT is of value to patients is the subject of two randomized prospective studies. The benefit of adjuvant RT is a matter of controversy. Salvage RT treats only those patients with proven residual prostate cancer. The salvage RT approach has several advantages. This approach spares approximately 40{\%} of patients who have had an RRP for T3 or T4 prostate cancer and eliminates the risks and costs associated with adjuvant RT. Additionally, it appears that the results of immediate adjuvant RT are similar to those achieved with early salvage RT.",
keywords = "Adjuvant therapy, Prostate cancer, Radiation therapy, Salvage therapy",
author = "Schild, {Steven E.}",
year = "2001",
month = "4",
day = "20",
doi = "10.1002/ijc.1012",
language = "English (US)",
volume = "96",
pages = "94--98",
journal = "International Journal of Cancer",
issn = "0020-7136",
publisher = "Wiley-Liss Inc.",
number = "2",

}

TY - JOUR

T1 - Radiation therapy (RT) after prostatectomy

T2 - The case for salvage therapy as opposed to adjuvant therapy

AU - Schild, Steven E.

PY - 2001/4/20

Y1 - 2001/4/20

N2 - Patients with pathologic stage T3 or T4 prostate cancer who have undetectable PSA levels following radical retropubic prostatectomy (RRP) have a substantial risk of recurrence. Radiotherapy (RT) can be administered immediately following the RRP (immediate adjuvant RT) or may be postponed until the PSA level has risen to a level that is indicative of residual or recurrent prostate cancer (salvage RT). Immediate adjuvant RT can significantly reduce the risk of relapse, but does not appear to increase the rate of survival. Approximately two-thirds of patients with rising PSA levels after RRP can be salvaged with RT alone. This result was achieved in patients treated with an adequate dose of radiation before the PSA rose to > 1.1 ng/ml. While no one can be certain which approach (adjuvant or salvage RT) is better, future studies should examine this issue. Whether immediate postoperative adjuvant RT is of value to patients is the subject of two randomized prospective studies. The benefit of adjuvant RT is a matter of controversy. Salvage RT treats only those patients with proven residual prostate cancer. The salvage RT approach has several advantages. This approach spares approximately 40% of patients who have had an RRP for T3 or T4 prostate cancer and eliminates the risks and costs associated with adjuvant RT. Additionally, it appears that the results of immediate adjuvant RT are similar to those achieved with early salvage RT.

AB - Patients with pathologic stage T3 or T4 prostate cancer who have undetectable PSA levels following radical retropubic prostatectomy (RRP) have a substantial risk of recurrence. Radiotherapy (RT) can be administered immediately following the RRP (immediate adjuvant RT) or may be postponed until the PSA level has risen to a level that is indicative of residual or recurrent prostate cancer (salvage RT). Immediate adjuvant RT can significantly reduce the risk of relapse, but does not appear to increase the rate of survival. Approximately two-thirds of patients with rising PSA levels after RRP can be salvaged with RT alone. This result was achieved in patients treated with an adequate dose of radiation before the PSA rose to > 1.1 ng/ml. While no one can be certain which approach (adjuvant or salvage RT) is better, future studies should examine this issue. Whether immediate postoperative adjuvant RT is of value to patients is the subject of two randomized prospective studies. The benefit of adjuvant RT is a matter of controversy. Salvage RT treats only those patients with proven residual prostate cancer. The salvage RT approach has several advantages. This approach spares approximately 40% of patients who have had an RRP for T3 or T4 prostate cancer and eliminates the risks and costs associated with adjuvant RT. Additionally, it appears that the results of immediate adjuvant RT are similar to those achieved with early salvage RT.

KW - Adjuvant therapy

KW - Prostate cancer

KW - Radiation therapy

KW - Salvage therapy

UR - http://www.scopus.com/inward/record.url?scp=0035917912&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0035917912&partnerID=8YFLogxK

U2 - 10.1002/ijc.1012

DO - 10.1002/ijc.1012

M3 - Article

C2 - 11291092

AN - SCOPUS:0035917912

VL - 96

SP - 94

EP - 98

JO - International Journal of Cancer

JF - International Journal of Cancer

SN - 0020-7136

IS - 2

ER -