Adjuvant radiotherapy following radical prostatectomy for pathologic T3 or margin-positive prostate cancer: A systematic review and meta-analysis

Salvage versus adjuvant radiotherapy after radical prostatectomy: argument for adjuvant radiotherapy

“…On meta-analysis of 1743 patients from the 3 randomized trials, ART resulted in improved biochemical progression-free survival (HR = 0.47, p < 0.001) and deferred requirement for adjuvant therapies (radiation and androgen ablation) with their associated adverse effects. 4 The biggest criticism directed at ART is that, up until recently, there had been no benefit in overall survival, likely because of the low number of deaths in either group. However, an updated analysis of SWOG 8794, presented at the 2008 American Urological Association Annual Meeting, shows increased metastatic-free survival (p = 0.021) and increased overall survival (median 15.2 yr compared with 13.5 yr, p = 0.031), in addition to increased biochemical control (p < 0.001) for the ART group, indicating unequivocal benefit for ART with level I evidence.…”

Assessing guideline impact on referral patterns of postprostatectomy patients to radiation oncologists

“…5 Similarly, the 10-year followup data from the European Organization for Research and Treatment of Cancer (EORTC) 22911 trial confirms biochemical progression-free survival benefit and reports a clinical progression-free survival benefit with patients who underwent aRT. 6 Following publication of these trials and a meta-analysis, 7 the Genitourinary Radiation Oncologists of Canada (GUROC) issued a consensus statement advising a consultation with a radiation oncologist (RO) early in the postoperative period to discuss benefits and side effects of aRT in those with HRF. 8 The American Urological Association (AUA) and American Society for Therapeutic Radiation Oncology (ASTRO) have also issued similar recommendations in their guidelines.…”

Variation in Clinical Target Volumes for Post-prostatectomy Patients and Effect on Normal Tissue Complication Probability

“…Adjuvant or salvage RT following radical prostatectomy is commonly prescribed for prostate cancer to limit local recurrence and improve disease-free and overall survival [5][6][7][8][9][10][11]. In this setting, prescribing physicians cannot base their clinical target volume (CTV) on the anatomical borders of a defined structure, but must rely on experience and published contouring atlases to determine regions at risk for microscopic disease, possibly increasing variation in treatment volume delineation [12][13][14][15].…”