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Randomized Trials for Adjuvant Radiotherapy

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Radiotherapy in Prostate Cancer

Part of the book series: Medical Radiology ((Med Radiol Radiat Oncol))

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Abstract

The optimal management of patients with adverse clinical and pathologic features concerning the risk of a biochemical recurrence after radical prostatectomy is still under discussion. The two treatment approaches for patients with undetectable PSA are immediate adjuvant radiotherapy or observation followed by early salvage radiation therapy in case of PSA increase out of the undetectable range. The purpose of this chapter is to review the rationale, results, and possible side effects of adjuvant radiotherapy with main focus on the three randomized phase III trials: Southwest Oncology Group (SWOG) 8794, the European Organization for Research and Treatment of Cancer (EORTC 22911), and the German Cancer Society (ARO 96-96/AUOAP 09/95). All three trials demonstrated a benefit in terms of bNED (biochemically no evidence of disease) after adjuvant radiotherapy compared to a “wait-and-see” policy. The greatest benefit was achieved in patients with positive margins and pT3 tumors. The rate of side effects was comparably low. It remains unknown if early salvage radiation therapy initiated after PSA failure is equivalent to adjuvant radiotherapy. At the present time, there are no published randomized trials to compare adjuvant radiotherapy versus salvage radiation therapy.

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References

  • Abdollah F, Boorjian S, Cozzarini C (2013) Survival following biochemical recurrence after radical prostatectomy and adjuvant radiotherapy in patients with prostate cancer: the impact of competing causes of mortality and patient stratification. Eur Urol 64:557–564

    Article  PubMed  Google Scholar 

  • Allsbrook WC Jr, Mangold KA, Johnson MH et al (2001a) Interobserver reproducibility of Gleason grading of prostatic carcinoma: urologic pathologists. Hum Pathol 32:74–80

    Article  PubMed  Google Scholar 

  • Allsbrook WC Jr, Mangold KA, Johnson MH et al (2001b) Interobserver reproducibility of Gleason grading of prostatic carcinoma: general pathologist. Hum Pathol 32:81–88

    Article  PubMed  Google Scholar 

  • Bartkowiak D, Bottke D, Wiegel T (2013a) Adjuvant radiotherapy or early salvage radiotherapy in pT3R0 or pT3R1 prostate cancer. Curr Opin Urol 23:360–365

    Article  PubMed  Google Scholar 

  • Bartkowiak D, Bottke D, Wiegel T (2013b) Radiotherapy in the management of prostate cancer after radical prostatectomy. Future Oncol 9:669–679

    Article  CAS  PubMed  Google Scholar 

  • Bartkowiak D, Humble N, Suhr P et al (2012) Second cancer after radiotherapy, 1981–2007. Radiother Oncol 105:122–126

    Article  PubMed  Google Scholar 

  • Begg CB, Riedel ER, Bach PB et al (2002) Variations in morbidity after radical prostatectomy. N Engl J Med 346:1138–1144

    Article  PubMed  Google Scholar 

  • Bernard JR Jr, Buskirk SJ, Heckman MG et al (2010) Salvage radiotherapy for rising prostate-specific antigen levels after radical prostatectomy for prostate cancer: dose-response analysis. Int J Radiat Oncol Biol Phys 76:735–740

    Article  PubMed  Google Scholar 

  • Bianco FJ Jr, Scardino PT, Eastham JA (2005) Radical prostatectomy: long-term cancer control and recovery of sexual and urinary function (“trifecta”). Urology 66:83–94

    Article  PubMed  Google Scholar 

  • Bolla M, De Reijke TM, Van Tienhoven G et al (2009) Duration of androgen suppression in the treatment of prostate cancer. N Engl J Med 360:2516–2527

    Article  CAS  PubMed  Google Scholar 

  • Bolla M, Van Poppel H, Collette L et al (2005) Postoperative radiotherapy after radical prostatectomy: a randomised controlled trial (EORTC trial 22911). Lancet 366:572–578

    Article  PubMed  Google Scholar 

  • Bolla M, Van Poppel H, Tombal B et al (2012) Postoperative radiotherapy after radical prostatectomy for high-risk prostate cancer: long-term results of a randomised controlled trial (EORTC trial 22911). Lancet 380:2018–2027

    Article  PubMed  Google Scholar 

  • Bottke D, Abrahamsson PA, Welte B et al (2007) Adjuvant radiotherapy after radical prostatectomy. Eur J Cancer Suppl 5:171–176

    Article  Google Scholar 

  • Bottke D, Bartkowiak D, Schrader M et al (2012) Radiotherapy after radical prostatectomy: immediate or early delayed? Strahlenther Onkol 188:1096–1101

    Article  CAS  PubMed  Google Scholar 

  • Bottke D, Kristiansen G, Golz R et al (2013a) Central pathology review: a must for prostate cancer studies and an option for selected patients in daily practise. Eur Urol 64:202–203

    Article  Google Scholar 

  • Bottke D, Golz R, Störkel S et al (2013b) Phase 3 study of adjuvant radiotherapy versus wait and see in pT3 prostate cancer: Impact of pathology review on analysis. Eur Urol 64:193–198

    Article  PubMed  Google Scholar 

  • Briganti A, Karnes RJ, Da Pozzo LF et al (2011) Combination of adjuvante hormonal and radiation therapy significantly prolongs survival of patients with pT2-4 pN + prostate cancer: results of a matched analysis. Eur Urol 59:832–840

    Article  CAS  PubMed  Google Scholar 

  • Briganti A, Wiegel T, Joniau S et al (2012) Early salvage radiation therapy does not compromise cancer control in patients with pT3N0 prostate cancer after radical prostatectomy: results of a match-controlled multi-institutional analysis. Eur Urol 62:472–487

    Article  PubMed  Google Scholar 

  • Budaus L, Bolla M, Bossi A et al (2012) Functional outcomes and complications following radiation therapy for prostate cancer: a critical analysis of the literature. Eur Urol 61:112–127

    Article  PubMed  Google Scholar 

  • Budiharto T, Perneel C, Haustermans K et al (2010) A multi-institutional analysis comparing adjuvant and salvage radiation therapy for high-risk prostate cancer patients with undetectable PSA after prostatectomy. Radiother Oncol 97:474–479

    Article  PubMed  Google Scholar 

  • Chikkaveeraiah BV, Mani V, Patel V et al (2011) Microfluidic electrochemical immunoarray for ultrasensitive detection of two cancer biomarker proteins in serum. Biosens Bioelectron 26:4477–4483

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  • Chun FK, Graefen M, Zacharias M et al (2006) Anatomic radical retropubic prostatectomy-long-term recurrence-free survival rates for localized prostate cancer. World J Urol 24:273–280

    Article  PubMed  Google Scholar 

  • Cooperberg MR, Carroll PR, Klotz L (2011) Active surveillance for prostate cancer: progress and promise. J Clin Oncol 29:3669–3676

    Article  PubMed  Google Scholar 

  • Cooperberg MR, Pasta DJ, Elkin EP et al (2005) The University of California, San Francisco cancer of the prostate risk Assessment score: a straightforward and reliable preoperative predictor of disease recurrence after radical prostatectomy. J Urol 173:1938–1942

    Article  PubMed Central  PubMed  Google Scholar 

  • Corn BW, Winter K, Pilepich MV (1999) Does androgen suppression enhance the efficacy of postoperative irradiation? A secondary analysis of RTOG 85-31. Radiat Ther Oncol Group Urol 54:495–502

    CAS  Google Scholar 

  • Da Pozzo LF, Cozzarini C, Briganti A et al (2009) Long-term follow-up of patients with prostate cancer and nodal metastases treated by pelvic lymphadenectomy and radical prostatectomy: the positive impact of adjuvant radiotherapy. Eur Urol 55:1003–1011

    Article  PubMed  Google Scholar 

  • Daly T, Hickey BE, Lehman M et al (2011) Adjuvant radiotherapy following radical prostatectomy for prostate cancer. Cochrane Database Syst Rev 12:CD007234

    Google Scholar 

  • Ekici S, Ayhan A, Erkan I et al (2003) The role of the pathologist in the evaluation of radical prostatectomy specimens. Scand J Urol Nephrol 37:387–391

    Article  PubMed  Google Scholar 

  • Elshaikh MA, Ibrahim DR, Stricker H et al (2011) Adjuvant radiation treatment after prostatectomy. Where do we stand? Can J Urol 18:5592–5600

    PubMed  Google Scholar 

  • Evans AJ, Henry PC, Van der Kwast TH et al (2008) Interobserver variability between expert urologic pathologists for extraprostatic extension and surgical margin status in radical prostatectomy specimens. Am J Surg Pathol 32:1503–1512

    Article  PubMed  Google Scholar 

  • Formenti SC, Lieskovsky G, Simoneau AR et al (1996) Impact of moderate dose of postoperative radiation on urinary continence and potency in patients with prostate cancer treated with nerve sparing prostatectomy. J Urol 155:616–619

    Article  CAS  PubMed  Google Scholar 

  • Freedland SJ, Humphreys EB, Mangold LA et al (2005) Risk of prostate cancer-specific mortality following biochemical recurrence after radical prostatectomy. JAMA 294:433–439

    Article  CAS  PubMed  Google Scholar 

  • Glaessgen A, Hamberg H, Pihl CG et al (2004a) Interobserver reproducibility of modified Gleason score in radical prostatectomy specimens. Virchows Arch 445:17–21

    PubMed  Google Scholar 

  • Glaessgen A, Hamberg H, Pihl CG et al (2004b) Interobserver reproducibility of percent Gleason grade 4/5 in prostate biopsies. J Urol 171:664–667

    Article  PubMed  Google Scholar 

  • Gomez P, Manoharan M, Kim SS et al (2004) Radionuclide bone scintigraphy in patients with biochemical recurrence after radical prostatectomy: when is it indicated? BJU Int 94:299–302

    Article  PubMed  Google Scholar 

  • Hanlon AL, Horwitz EM, Hanks GE et al (2004) Short-term androgen deprivation and PSA doubling time: their association and relationship to disease progression after radiation therapy for prostate cancer. Int J Radiat Oncol Biol Phys 58:43–52

    Article  CAS  PubMed  Google Scholar 

  • Heidenreich A, Bellmunt J, Bolla M et al (2011) EAU guidelines on prostate cancer. Part 1: screening, diagnosis, and treatment of clinically localised disease. Eur Urol 59:61–71

    Article  PubMed  Google Scholar 

  • Hoffman KE, Nguyen PL, Chen MH et al (2011) Recommendations for post-prostatectomy radiation therapy in the United States before and after the presentation of randomized trials. J Urol 185:116–120

    Article  PubMed  Google Scholar 

  • Horwitz EM, Bae K, Hanks GE et al (2008) Ten-year follow-up of radiation therapy oncology group protocol 92-02: a phase III trial of the duration of elective androgen deprivation in locally advanced prostate cancer. J Clin Oncol 26:2497–2504

    Article  CAS  PubMed  Google Scholar 

  • Kaminski JM, Hanlon AL, Joon DL et al (2003) Effect of sequencing of androgen deprivation and radiotherapy on prostate cancer growth. Int J Radiat Oncol Biol Phys 57:24–28

    Article  CAS  PubMed  Google Scholar 

  • Kawamorita N, Saito S, Ishidoya S et al (2009) Radical prostatectomy for high-risk prostate cancer: biochemical outcome. Int J Urol 16:733–738

    Article  PubMed  Google Scholar 

  • King CR (2012) Adjuvant versus salvage radiotherapy after prostatectomy: the apple versus the orange. Int J Radiat Oncol Biol Phys 82:1045–1046

    Article  PubMed  Google Scholar 

  • King CR, Kapp DS (2008) Radiotherapy after prostatectomy: is the evidence for dose escalation out there? Int J Radiat Oncol Biol Phys 71:346–350

    Article  PubMed  Google Scholar 

  • King CR, Presti JC Jr, Gill H et al (2004) Radiotherapy after radical prostatectomy: does transient androgen suppression improve outcomes? Int J Radiat Oncol Biol Phys 59:341–347

    Article  PubMed  Google Scholar 

  • Kyrdalen AE, Dahl AA, Hernes E et al (2013) A national study of adverse effects and global quality of life among candidates for curative treatment for prostate cancer. BJU Int 111:221–232

    Article  PubMed  Google Scholar 

  • Kuroiwa K, Shiraishi T, Ogawa O et al (2010) Discrepancy between local and central pathological review of radical prostatectomy specimens. J Urol 183:952–957

    Article  PubMed  Google Scholar 

  • Lawton CA, Winter K, Murray K et al (2001) Updated results of the phase III radiation therapy oncology group (RTOG) trial 85-31 evaluating the potential benefit of androgen suppression following standard radiation therapy for unfavorable prognosis carcinoma of the prostate. Int J Radiat Oncol Biol Phys 49:937–946

    Article  CAS  PubMed  Google Scholar 

  • Loeb S, Roehl KA, Viprakasit DP et al (2008) Long-term rates of undetectable PSA with initial observation and delayed salvage radiotherapy after radical prostatectomy. Eur Urol 54:88–94

    Article  PubMed  Google Scholar 

  • Lotan Y, Roehrborn CG (2002) Clearance rates of total prostate specific antigen (PSA) after radical prostatectomy in African-Americans and Caucasians. Prostate Cancer Prostatic Dis 5:111–144

    Article  CAS  PubMed  Google Scholar 

  • McVey GP, McPhail S, Fowler S et al (2010) Initial management of low-risk localized prostate cancer in the UK: analysis of the British association of urological surgeons cancer registry. BJU Int 106:1161–1164

    Article  PubMed  Google Scholar 

  • Michalski JM, Lawton C, El Naqa I et al (2010) Development of RTOG consensus guidelines for the definition of the clinical target volume for postoperative conformal radiation therapy for prostate cancer. Int J Radiat Oncol Biol Phys 76:361–368

    Article  PubMed Central  PubMed  Google Scholar 

  • Mottet N, Bellmunt J, Bolla M et al (2011) EAU guidelines on prostate cancer. Part II: treatment of advanced, relapsing, and castration-resistant prostate cancer. Eur Urol 59:572–583

    Article  PubMed  Google Scholar 

  • Netto GJ, Eisenberger M, Epstein JI (2011) Interobserver variability in histologic evaluation of radical prostatectomy between central and local pathologists: findings of TAX 3501 multinational clinical trial. Urology 77:1155–1157

    Article  PubMed Central  PubMed  Google Scholar 

  • Neuhof D, Hentschel T, Bischof M et al (2007) Long-term results and predictive factors of three-dimensional conformal salvage radiotherapy for biochemical relapse after prostatectomy. Int J Radiat Oncol Biol Phys 67:1411–1417

    Article  PubMed  Google Scholar 

  • Ost P, De Troyer B, Fonteyne V et al (2011) A matched control analysis of adjuvant and salvage high-dose postoperative intensity-modulated radiotherapy for prostate cancer. Int J Radiat Oncol Biol Phys 80:1316–1322

    Article  PubMed  Google Scholar 

  • Oyama T, Allsbrook WC Jr, Kurokawa K et al (2005) A comparison of interobserver reproducibility of Gleason grading of prostatic carcinoma in Japan and the United States. Arch Pathol Lab Med 129:1004–1010

    PubMed  Google Scholar 

  • Parker C, Sydes MR, Catton C et al (2007) Radiotherapy and androgen deprivation in combination after local surgery (RADICALS): a new medical research council/national cancer institute of Canada phase III trial of adjuvant treatment after radical prostatectomy. BJU Int 99:1376–1379

    Article  PubMed  Google Scholar 

  • Petrovich Z, Lieskovsky G, Langholz B (2002) Postoperative radiotherapy in 423 patients with pT3N0 prostate cancer. Int J Radiat Oncol Biol Phys 53:600–609

    Article  PubMed  Google Scholar 

  • Petrovich Z, Lieskovsky G, Langholz B (1991) Radiotherapy following radical prostatectomy in patients with adenocarcinoma of the prostate. Int J Radiat Oncol Biol Phys 21:949–954

    Article  CAS  PubMed  Google Scholar 

  • Pfitzenmaier J, Pahernik S, Tremmel T et al (2008) Positive surgical margins after radical prostatectomy: do they have an impact on biochemical or clinical progression? BJU Int 102:1413–1418

    Article  PubMed  Google Scholar 

  • Pinto F, Prayer-Galetti T, Gardiman M et al (2006) Clinical and pathological characteristics of patients presenting with biochemical progression after radical retropubic prostatectomy for pathologically organ-confined prostate cancer. Urol Int 76:202–208

    Article  CAS  PubMed  Google Scholar 

  • Poortmans P, Bossi A, Vandeputte K et al (2007) Guidelines for target volume definition in post-operative radiotherapy for prostate cancer, on behalf of the EORTC radiation oncology group. Radiother Oncol 84:121–127

    Article  PubMed  Google Scholar 

  • Richaud P, Sargos P, Henriques de Figueiredo B et al (2010) Postoperative radiotherapy of prostate cancer. Cancer Radiother 14:500–503

    Google Scholar 

  • Rossi CJ Jr, Joe Hsu IC, Abdel-Wahab M et al (2011) ACR appropriateness criteria postradical prostatectomy irradiation in prostate cancer. Am J Clin Oncol 34:92–98

    Google Scholar 

  • Salomon L, Anastasiadis AG, Antiphon P et al (2003) Prognostic consequences of the location of positive surgical margins in organ-confined prostate cancer. Urol Int 70:291–296

    Article  PubMed  Google Scholar 

  • Shekarriz B, Upadhyay J, Wood DP Jr et al (1999) Vesicourethral anastomosis biopsy after radical prostatectomy: predictive value of prostate-specific antigen and pathologic stage. Urology 54:1044–1048

    Article  CAS  PubMed  Google Scholar 

  • Showalter TN, Ohri N, Teti KG et al (2012) Physician beliefs and practices for adjuvant and salvage radiation therapy after prostatectomy. Int J Radiat Oncol Biol Phys 82:e233–e238

    Article  PubMed  Google Scholar 

  • Siegmann A, Bottke D, Faehndrich J et al (2011) Dose escalation for patients with decreasing PSA during radiotherapy for elevated PSA after radical prostatectomy improves biochemical progression-free survival: results of a retrospective study. Strahlenther Onkol 187:467–472

    Article  PubMed  Google Scholar 

  • Stephenson AJ, Bolla M, Briganti A et al (2012) Postoperative radiation therapy for pathologically advanced prostate cancer after radical prostatectomy. Eur Urol 61:443–451

    Article  PubMed  Google Scholar 

  • Stephenson AJ, Kattan MW, Eastham JA et al (2006) Defining biochemical recurrence of prostate cancer after radical prostatectomy: a proposal for a standardized definition. J Clin Oncol 24:3973–3978

    Article  CAS  PubMed  Google Scholar 

  • Stephenson AJ, Scardino PT, Kattan MW et al (2007) Predicting the outcome of salvage radiation therapy for recurrent prostate cancer after radical prostatectomy. J Clin Oncol 25:2035–2041

    Article  PubMed Central  PubMed  Google Scholar 

  • Stephenson AJ, Wood DP, Kattan MW et al (2009) Location, extent and number of positive surgical margins do not improve accuracy of predicting prostate cancer recurrence after radical prostatectomy. J Urol 182:1357–1363

    Article  PubMed  Google Scholar 

  • Swanson GP, Hussey MA, Tangen CM et al (2007) Predominant treatment failure in postprostatectomy patients is local: analysis of patterns of treatment failure in SWOG 8794. J Clin Oncol 25:2225–2229

    Article  PubMed  Google Scholar 

  • Swindle P, Eastham JA, Ohori M et al (2005) Do margins matter? The prognostic significance of positive surgical margins in radical prostatectomy specimens. J Urol 174:903–907

    Article  PubMed  Google Scholar 

  • Thompson IM Jr, Tangen CM, Paradelo J et al (2006) Adjuvant radiotherapy for pathologically advanced prostate cancer: a randomized clinical trial. JAMA 296:2329–2335

    Article  CAS  PubMed  Google Scholar 

  • Thompson IM, Tangen CM, Paradelo J et al (2009) Adjuvant radiotherapy for pathological T3N0M0 prostate cancer significantly reduces risk of metastases and improves survival: long-term followup of a randomized clinical trial. J Urol 181:956–962

    Article  PubMed Central  PubMed  Google Scholar 

  • Thompson IM, Valicenti RK, Albertsen P et al (2013) Adjuvant and salvage radiotherapy after prostatectomy: AUA/ASTRO guideline. J Urol 190:441–449

    Article  PubMed  Google Scholar 

  • Trabulsi EJ, Valicenti RK, Hanlon AL et al (2008) A multi-institutional matched-control analysis of adjuvant and salvage postoperative radiation therapy for pT3-4N0 prostate cancer. Urology 72:1298–1302; discussion 1302–1294

    Google Scholar 

  • Triroj N, Jaroenapibal P, Shi H et al (2011) Microfluidic chip-based nanoelectrode array as miniaturized biochemical sensing platform for prostate-specific antigen detection. Biosens Bioelectron 26:2927–2933

    Article  CAS  PubMed  Google Scholar 

  • Trock BJ, Han M, Freedland SJ et al (2008) Prostate cancer-specific survival following salvage radiotherapy vs observation in men with biochemical recurrence after radical prostatectomy. JAMA 299:2760–2769

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  • Tyldesley S, Peacock M, Morris JW et al (2012) The need for, and utilization of prostate-bed radiotherapy after radical prostatectomy for patients with prostate cancer in British Columbia. Can Urol Assoc J 6:89–94

    Article  PubMed Central  PubMed  Google Scholar 

  • Valicenti RK, Gomella LG (2000) Durable efficacy of adjuvant radiation therapy for prostate cancer: will the benefit last? Semin Urol Oncol 18:115–120

    CAS  PubMed  Google Scholar 

  • Van Cangh PJ, Richard F, Lorge F et al (1998) Adjuvant radiation therapy does not cause urinary incontinence after radical prostatectomy: results of a prospective randomized study. J Urol 159:164–166

    Article  PubMed  Google Scholar 

  • Van der Kwast TH, Collette L, Van Poppel H et al (2006) Impact of pathology review of stage and margin status of radical prostatectomy specimens (EORTC trial 22911). Virchows Arch 449:428–434

    Article  PubMed  Google Scholar 

  • Van der Kwast TH, Bolla M, van Poppel H et al (2007) Identification of patients with prostate cancer who benefit from immediate postoperative radiotherapy: EORTC 22911. J Clin Oncol 25:4178–4186

    Article  PubMed  Google Scholar 

  • Wenz F, Martin T, Böhmer D et al (2010) The German S3 guideline prostate cancer: aspects for the radiation oncologist. Strahlenther Onkol 186:531–534

    Article  PubMed  Google Scholar 

  • Wiegel T, Albers P, Bussar-Maatz R et al (2013a) PREFERE—the German prostatic cancer study: questions and claims surrounding study initiation in January 2013. Urol A 52:576–579

    Article  CAS  Google Scholar 

  • Wiegel T, Bottke D, Bartkowiak D et al (2013b) Phase III results of adjuvant radiotherapy versus wait-and-see in patients with pT3 prostate cancer following radical prostatectomy (ARO96-02/AUO AP 9/95). In: Genitourinary Cancers Symposium, Abstract 4. Presented, 14 Feb 2013

    Google Scholar 

  • Wiegel T, Bottke D, Steiner U et al (2009a) Phase III postoperative adjuvant radiotherapy after radical prostatectomy compared with radical prostatectomy alone in pT3 prostate cancer with postoperative undetectable prostate-specific antigen: ARO 96-02/AUO AP 09/95. J Clin Oncol 27:2924–2930

    Article  PubMed  Google Scholar 

  • Wiegel T, Lohm G, Bottke D et al (2009b) Achieving an undetectable PSA after radiotherapy for biochemical progression after radical prostatectomy is an independent predictor of biochemical outcome–results of a retrospective study. Int J Radiat Oncol Biol Phys 73:1009–1016

    Article  PubMed  Google Scholar 

  • Wiltshire KL, Brock KK, Haider MA et al (2007) Anatomic boundaries of the clinical target volume (prostate bed) after radical prostatectomy. Int J Radiat Oncol Biol Phys 69:1090–1099

    Article  PubMed  Google Scholar 

  • Zelefsky MJ, Housman DM, Pei X et al (2012) Incidence of secondary cancer development after high-dose intensity-modulated radiotherapy and image-guided brachytherapy for the treatment of localized prostate cancer. Int J Radiat Oncol Biol Phys 83:953–959

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Radiotherapy and Radiation Oncology, University Hospital Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Germany

    Dirk Bottke

  2. Klinik für Strahlentherapie und Radioonkologie, Universitätsklinikum Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Germany

    Thomas Wiegel

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  1. Dirk Bottke
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Correspondence to Dirk Bottke .

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Editors and Affiliations

  1. Department of Radiation Oncology, Krankenhaus der Barmherzigen, Schwestern Linz, Johannes Kepler University, Linz, Austria

    Hans Geinitz

  2. University of California, San Francisco Department of Radiation Oncology, San Francisco, California, USA

    Mack Roach III

  3. The Institute of Cancer Research Sutton, Sutton Surrey, United Kingdom

    Nicholas van As

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Bottke, D., Wiegel, T. (2014). Randomized Trials for Adjuvant Radiotherapy. In: Geinitz, H., Roach III, M., van As, N. (eds) Radiotherapy in Prostate Cancer. Medical Radiology(). Springer, Berlin, Heidelberg. https://doi.org/10.1007/174_2013_948

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