ACR appropriateness criteria® postradical prostatectomy irradiation in prostate cancer

Carl J. Rossi, I. Chow Joe Hsu, May Abdel-Wahab, V. Elayne Arterbery, Jay P. Ciezki, Steven J. Frank, Noah M. Hahn, Brian J. Moran, Seth A. Rosenthal, Gregory Merrick

Research output: Contribution to journalArticlepeer-review

Abstract

The role of postradical prostatectomy radiation therapy continues to evolve under the influence of new clinical data. In particular, 2 recently published or updated randomized trials have prompted a reevaluation of its utility in the adjuvant and salvage setting. The Southwest Oncology Group 8794 trial randomized 473 patients with stage T3a-T3b disease to adjuvant radiotherapy versus observation. With a median follow-up of 12.7 years, this trial demonstrates an improvement in metastasis-free (93/214 vs. 114/211, P = 0.016) and overall survival (88 vs. 110 deaths, P = 0.023) favoring adjuvant radiotherapy. The European Organization for Research and Treatment of Cancer 22911 study of 972 patients with at least 1 "high risk" feature at surgery (extracapsular extension, positive surgical margins, seminal vesicle involvement) randomized to immediate adjuvant radiotherapy (60 Gy) versus observation. The freedom from biochemical failure at 5 years was 53% in the observation alone group versus 74% in the adjuvant radiotherapy group (P < 0.0001). This review summarizes the current evidence-based literature supporting the use of postradical prostatectomy radiation therapy in various common clinical settings and will serve to illustrate the appropriateness of postoperative radiotherapy by reviewing its implementation in a variety of commonly occurring clinical scenarios. It is intended to serve both as a guideline for the practicing radiation oncologist and a resource for further learning.

Original languageEnglish (US)
Pages (from-to)92-98
Number of pages7
JournalAmerican Journal of Clinical Oncology: Cancer Clinical Trials
Volume34
Issue number1
DOIs
StatePublished - Feb 1 2011
Externally publishedYes

Keywords

  • adjuvant radiotherapy
  • appropriateness criteria
  • prostate cancer
  • radical prostatectomy
  • salvage radiotherapy

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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