Radiotherapy in the Management of Prostate Cancer After Radical Prostatectomy

Detlef Bartkowiak; Dirk Bottke; Thomas Wiegel


Future Oncol. 2013;9(5):669-679. 

In This Article

Conclusion & Recommendations

Treatment decisions after prostatectomy require risk assessment. This is now facilitated by the Markov projection[102] and validated nomograms.[19,71,82,107–109] For low-to-intermediate-risk PC, observation and SRT can be recommended after R0 resection. Upon reincreasing PSA, SRT with at least 66 Gy should be applied as soon as possible (PSA <0.5 ng/ml). Until the ongoing trials[45,47,205] hopefully settle the question about when ART (with 60–64 Gy) is the better choice, ART should be regarded as an option at least in the case of R1.[54] Even now there is evidence that modern techniques (IMRT and image-guided RT) should offer an improved tumor control and help to minimize side effects.[89,110]