Post-prostatectomy radiation therapy for locally recurrent prostate cancer

Sudhir Isharwal, Andrew J. Stephenson

Research output: Contribution to journalReview articlepeer-review

5 Scopus citations


Introduction: Approximately 15–30% of men with localized prostate cancer will experience biochemical recurrence (BCR) after radical prostatectomy. Postoperative radiation therapy is used in men with adverse pathological features to reduce the risk of BCR or with curative intent in men with known BCR. In this study, we review the evidence for the adjuvant and salvage radiation therapy after radical prostatectomy. Areas covered: A literature review of the Medline and Embase databases was performed. The search strategy included the following terms: prostate cancer, adjuvant radiotherapy, salvage radiotherapy, radical prostatectomy, biochemical recurrence, and prostate cancer recurrence. Prospective randomized trials for the adjuvant radiotherapy and observational studies supporting salvage radiotherapy were included for discussion. Expert commentary: As postoperative radiotherapy is associated with non-trivial risks of acute and long-term toxicity and given the absence of compelling data supporting adjuvant over early salvage radiotherapy, the authors advocate, with rare exceptions, close observation and timely (early) salvage radiotherapy for patients with BCR and long life expectancy. Adjuvant radiotherapy may be considered in patients at high-risk for recurrence. Observation is appropriate in patients with limited life expectancy and/or absence of adverse features.

Original languageEnglish (US)
Pages (from-to)1003-1012
Number of pages10
JournalExpert review of anticancer therapy
Issue number11
StatePublished - Nov 2 2017
Externally publishedYes


  • Radiotherapy
  • adjuvant
  • cancer recurrence
  • prostate cancer
  • prostate-specific antigen
  • prostatectomy
  • salvage

ASJC Scopus subject areas

  • Oncology
  • Pharmacology (medical)


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