Randomized Trials for Adjuvant Radiotherapy

Part of the Medical Radiology book series (MEDRAD)


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.


Radical Prostatectomy Gleason Score Positive Surgical Margin Biochemical Recurrence Pelvic Lymph Node Dissection 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  1. 1.Department of Radiotherapy and Radiation OncologyUniversity Hospital UlmUlmGermany
  2. 2.Klinik für Strahlentherapie und RadioonkologieUniversitätsklinikum UlmUlmGermany

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