TY - JOUR
T1 - Salvage radical prostatectomy after external beam radiation therapy
T2 - A systematic review of current approaches
AU - Matei, Deliu Victor
AU - Ferro, Matteo
AU - Jereczek-Fossa, Barbara Alicja
AU - Renne, Giuseppe
AU - Crisan, Nicolae
AU - Bottero, Danilo
AU - Mazzarella, Claudia
AU - Terracciano, Daniela
AU - Autorino, Riccardo
AU - De Cobelli, Ottavio
PY - 2015/6/9
Y1 - 2015/6/9
N2 - Background: Radical external beam radiotherapy (EBRT) is a standard treatment for prostate cancer patients. Despite this, the rate of intraprostatic relapses after primary EBRT is still not negligible. There is no consensus on the most appropriate management of these patients after EBRT failure. For these patients, local salvage therapy such as radical prostatectomy, cryotherapy, and brachytherapy may be indicated. Objective: The objectives of this review were to analyze the eligibility criteria for careful selection of appropriate patients and to evaluate the oncological results and complications for each method. Methods: A review of the literature was performed to identify studies of local salvage therapy for patients who had failed primary EBRT for localized prostate cancer. Results: Most studies demonstrated that local salvage therapy after EBRT may provide long-term local control in appropriately selected patients, although toxicity is often significant. Conclusions: Our results suggest that for localized prostate cancer recurrence after EBRT, the selection of a local treatment modality should be made on a patient-by-patient basis. An improvement in selection criteria and an integrated definition of biochemical failure for all salvage methods are required to determine which provides the best oncological outcome and least comorbidity.
AB - Background: Radical external beam radiotherapy (EBRT) is a standard treatment for prostate cancer patients. Despite this, the rate of intraprostatic relapses after primary EBRT is still not negligible. There is no consensus on the most appropriate management of these patients after EBRT failure. For these patients, local salvage therapy such as radical prostatectomy, cryotherapy, and brachytherapy may be indicated. Objective: The objectives of this review were to analyze the eligibility criteria for careful selection of appropriate patients and to evaluate the oncological results and complications for each method. Methods: A review of the literature was performed to identify studies of local salvage therapy for patients who had failed primary EBRT for localized prostate cancer. Results: Most studies demonstrated that local salvage therapy after EBRT may provide long-term local control in appropriately selected patients, although toxicity is often significant. Conclusions: Our results suggest that for localized prostate cancer recurrence after EBRT, the selection of a local treatment modality should be made on a patient-by-patient basis. An improvement in selection criteria and an integrated definition of biochemical failure for all salvage methods are required to determine which provides the best oncological outcome and least comorbidity.
KW - External beam radiation therapy
KW - Oncologic outcome
KW - Prostate cancer recurrence
KW - Radiation therapy
KW - Salvage prostatectomy
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U2 - 10.1159/000371893
DO - 10.1159/000371893
M3 - Article
C2 - 25765848
AN - SCOPUS:84930577298
VL - 94
SP - 373
EP - 382
JO - Urologia Internationalis
JF - Urologia Internationalis
SN - 0042-1138
IS - 4
ER -