Significance of Whole-Pelvic Radiotherapy For High-Risk Prostate Cancer Patients After Radical Prostatectomy

Abstract

Evaluation of: Spiotto MT, Hancock SL, King CR: Radiotherapy after prostatectomy: improved biochemical relapse-free survival with whole pelvic compared with prostate bed only for high-risk patients.Int. J. Radiat. Oncol. Biol. Phys.69, 54–61 (2007). Although most patients with localized prostate cancer are successfully treated with radical prostatectomy, high-risk patients often manifest biochemical and/or clinical relapse. Adjuvant or salvage radiotherapy is utilized for the treatment of these patients. For definitive radiotherapy for untreated prostate cancer, a randomized clinical study (radiation therapy oncology group [RTOG] 94–13), suggested superior effects of whole-pelvic radiotherapy to prostate-only radiotherapy. On the contrary, for adjuvant or salvage radiotherapy after radical prostatectomy, the role of whole-pelvic radiotherapy has not been extensively investigated. This retrospective study demonstrated better biochemical relapse-free survival in high-risk patients receiving adjuvant or salvage whole-pelvic radiotherapy, when combined with concurrent hormonal therapy, compared with prostate bed radiotherapy. Selection for good candidates for whole-pelvic radiotherapy after radical prostatectomy will be confirmed in future and a large-scale randomized clinical trial is required before the final conclusion can be made.