The American Society for Radiation Oncology (ASTRO) and the American Urological Association (AUA) have released updates to their joint clinical guideline on adjuvant and salvage radiotherapy after prostatectomy.
Revisions in the "Adjuvant and Salvage Radiotherapy After Prostatectomy: ASTRO/AUA Guideline" cover patients with and without evidence of prostate cancer recurrence and include the following:
- Guidelines now account for the latest data from three randomized controlled trials evaluating the use of adjuvant radiotherapy, including new long-term data from the ARO 96-02 trial.
- New guidance states that patients with adverse pathologic findings including seminal vesicle invasion, positive surgical margins, and extraprostatic extension should be informed that adjuvant radiotherapy -- compared with radical prostatectomy only -- reduces the risk of biochemical (PSA) recurrence, local recurrence, and clinical progression of cancer.
- A new guideline statement includes outcome data from two randomized controlled trials (RTOG 9601 and GETUG-AFU 16) that evaluate the effects of hormonal therapy on overall survival, and on biochemical and clinical progression among patients who received salvage radiotherapy after prostatectomy. The trials found sufficiently strong evidence, overall, to encourage the offering of hormonal therapy to patients who are candidates for salvage radiotherapy.
- Additional guidance states that clinicians should offer hormonal therapy with radiotherapy to patients who are candidates for salvage radiation therapy. Ongoing research may someday allow personalized selection of hormonal or other therapies within patient subsets.
The full text is available in the Journal of Urology and Practical Radiation Oncology.
