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Guidelines Updated for Radiotherapy After Prostatectomy

FRIDAY, May 31, 2019 -- Clinical guidelines on adjuvant and salvage radiotherapy after radical prostatectomy have been updated, according to the American Society for Radiation Oncology and the American Urological Association.

Ian Murchie Thompson, M.D., from the University of Texas Health Science Center San Antonio, and colleagues updated guidelines developed from a review of the literature relevant to the use of radiotherapy after prostatectomy in the management of prostate cancer.

The authors amended various guideline statements. The latest data from three randomized clinical trials assessing the use of adjuvant radiotherapy were incorporated into the evidence base. For patients with adverse pathologic findings, adjuvant radiotherapy reduces the risk for biochemical recurrence, local recurrence, and cancer progression compared with radical prostatectomy alone. The impact on subsequent metastases and overall survival was not clear, with one trial indicating benefit and two not showing benefits. A new guideline statement, which included data from two randomized trials, indicated there is strong evidence to encourage hormone therapy to be offered to patients who are candidates for salvage radiotherapy. Personalized selection of hormonal or other therapies may one day be offered within patient subsets. In addition, new information related to genomic classifiers as predictors of treatment effectiveness was added to the future research needs.

"Our expectation is this guideline is fully aligned to the latest science and provides physicians with a relevant blueprint for the use of radiotherapy after prostatectomy," Thompson said in a statement.

Adjuvant and Salvage Radiotherapy after Prostatectomy: ASTRO/AUA Guideline

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Posted: May 2019

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