Radiotherapy before and after radical prostatectomy for high-risk and locally advanced prostate cancer.


Journal Article (Review)

OBJECTIVES: Men with localized high-risk prostate cancer carry significant risk of prostate cancer-specific mortality. The best treatment approach to minimize this risk is unclear. In this review, we evaluate the role of radiation before and after radical prostatectomy. METHODS AND MATERIALS: A critical review of the literature was performed regarding the application of external radiation therapy (RT) in combination with prostatectomy for high-risk localized prostate cancer. RESULTS: Up to 70% of men with high-risk localized disease may require adjuvant therapy because of adverse pathologic features or biochemical recurrence in the absence of systemic disease. The utility of adjuvant RT among men with adverse pathologic features are well established at least regarding minimizing biochemical recurrence risk. The optimal timing of salvage radiation is the subject of ongoing studies. Neoadjuvant RT requires further study but is a potentially attractive method because of decreased radiation field sizes and potential radiobiologic benefits of delivering RT before surgery. Salvage prostatectomy is effective at treating local recurrence after radiation but is associated with significant surgical morbidity. CONCLUSIONS: Combining local therapies including radical prostatectomy and RT can be a reasonable approach. Care should be taken at the initial presentation of high-risk localized prostate cancer to consider and plan for the likelihood of multimodality care.

Full Text

Duke Authors

Cited Authors

  • Perez, BA; Koontz, BF

Published Date

  • May 2015

Published In

Volume / Issue

  • 33 / 5

Start / End Page

  • 226 - 234

PubMed ID

  • 25454485

Pubmed Central ID

  • 25454485

Electronic International Standard Serial Number (EISSN)

  • 1873-2496

Digital Object Identifier (DOI)

  • 10.1016/j.urolonc.2014.09.018


  • eng

Conference Location

  • United States