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Postoperative Irradiation: Immediate or Early Delayed?

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Management of Prostate Cancer

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Abstract

Biochemical recurrence after radical prostatectomy (RP) is associated with risk factors including high baseline levels of prostate-specific antigen (PSA), extraprostatic extension, positive surgical margins (R1), and Gleason score ≥8. The 5-year biochemical progression rate for patients with these characteristics has been estimated to be as high as 50–70 %. Two treatment approaches for the postoperative management of these patients are adjuvant radiation therapy in men with an undetectable PSA or observation followed by early salvage radiation therapy (SRT) in men with persisting or rising PSA after initial postoperative undetectable values.

Three randomized phase III trials demonstrated a nearly 20 % absolute benefit for biochemical progression free survival after adjuvant radiation therapy (ART) (60–64 Gy) compared to a “wait-and-see” policy. The greatest benefit has been revealed in patients with positive margins and pT3 tumors.

SRT can be offered to patients with rising PSA after RP. Of these patients, 30–70 % will experience a decrease in their PSA to an undetectable range, and in about 40–50 % of these patients, the PSA will remain stable after 5 years.

At the present time, there are no published randomized trials to compare ART versus SRT.

The purpose of this chapter is to review the rationale, results, and possible side effects for the two treatment approaches ART and SRT.

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References

  1. Abdollah F, Karnes RJ, Suardi N, et al. Impact of adjuvant radiotherapy on survival of patients with node-positive prostate cancer. J Clin Oncol. 2014;32:3939–47.

    Article  PubMed  Google Scholar 

  2. Afshar-Oromieh A, Avtzi E, Giesel FL. The diagnostic value of PET/CT imaging with the (68)Ga-labelled PSMA ligand HBED-CC in the diagnosis of recurrent prostate cancer. Eur J Nucl Med Mol Imaging. 2015;42:197–209.

    Article  CAS  PubMed  Google Scholar 

  3. Afshar-Oromieh A, Zechmann CM, Malcher A, et al. Comparison of PET imaging with a (68)Ga-labelled PSMA ligand and (18)F-choline-based PET/CT for the diagnosis of recurrent prostate cancer. Eur J Nucl Med Mol Imaging. 2014;41:11–20.

    Article  CAS  PubMed  Google Scholar 

  4. Anscher MS, Clough R, Dodge R. Radiotherapy for a rising prostate-specific antigen after radical prostatectomy: the first 10 years. Int J Radiat Oncol Biol Phys. 2000;48:369–75.

    Article  CAS  PubMed  Google Scholar 

  5. Bartkowiak D, Bottke D, Thamm R, et al. The PSA-response to salvage radiotherapy after radical prostatectomy correlates with freedom from progression and overall survival. Radiother Oncol. 2016;118:131–5.

    Article  PubMed  Google Scholar 

  6. Bastasch MD, Teh BS, Mai WY, et al. Post-nerve-sparing prostatectomy, dose-escalated intensity-modulated radiotherapy: effect on erectile function. Int J Radiat Oncol Biol Phys. 2002;54:101–6.

    Article  PubMed  Google Scholar 

  7. Beer AJ, Eiber M, Souvatzoglou M, et al. Radionuclide and hybrid imaging of recurrent prostate cancer. Lancet Oncol. 2011;12:181–91.

    Article  PubMed  Google Scholar 

  8. Begg CB, Riedel ER, Bach PB, et al. Variations in morbidity after radical prostatectomy. N Engl J Med. 2002;346:1138–44.

    Article  PubMed  Google Scholar 

  9. Bernard Jr JR, Buskirk SJ, Heckman MG, et al. Salvage radiotherapy for rising prostate-specific antigen levels after radical prostatectomy for prostate cancer: dose–response analysis. Int J Radiat Oncol Biol Phys. 2010;76:735–40.

    Article  PubMed  Google Scholar 

  10. Bolla M, De Reijke TM, Van Tienhoven G, et al. Duration of androgen suppression in the treatment of prostate cancer. N Engl J Med. 2009;360:2516–27.

    Article  CAS  PubMed  Google Scholar 

  11. Bolla M, Van Poppel H, Collette L, et al. Postoperative radiotherapy after radical prostatectomy: a randomised controlled trial (EORTC trial 22911). Lancet. 2005;366:572–8.

    Article  PubMed  Google Scholar 

  12. Bolla M, van Poppel H, Tombal B. Postoperative radiotherapy after radical prostatectomy for high-risk prostate cancer: long-term results of a randomised controlled trial (EORTC trial 22911). Lancet. 2012;380:2018–27.

    Article  PubMed  Google Scholar 

  13. Boorjian SA, Karnes RJ, Crispen PL, et al. Radiation therapy after radical prostatectomy: impact on metastasis and survival. J Urol. 2009;182:2708–14.

    Article  PubMed  Google Scholar 

  14. Bottke D, Golz R, Störkel S, et al. Phase 3 study of adjuvant radiotherapy versus wait and see in pT3 prostate cancer: impact of pathology review on analysis. Eur Urol. 2013;64:193–8.

    Article  PubMed  Google Scholar 

  15. Briganti A, Karnes RJ, Da Pozzo LF, et al. 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. 2011;59:832–40.

    Article  CAS  PubMed  Google Scholar 

  16. Briganti A, Karnes RJ, Gandaglia G, et al. Natural history of surgically treated high-risk prostate cancer. Urol Oncol. 2015;33:163.e7-13.

    Article  PubMed  Google Scholar 

  17. Briganti A, Karnes RJ, Joniau S. Prediction of outcome following early salvage radiotherapy among patients with biochemical recurrence after radical prostatectomy. Eur Urol. 2014;66:479–86.

    Article  CAS  PubMed  Google Scholar 

  18. Briganti A, Wiegel T, Joniau S, et al. 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. 2012;62:472–87.

    Article  PubMed  Google Scholar 

  19. Budäus L, Leyh-Bannurah SR, Salomon G, Michl U, Heinzer H, Huland H, Graefen M, Steuber T, Rosenbaum C. Initial experience of (68)Ga-PSMA PET/CT imaging in high-risk prostate cancer patients prior to radical prostatectomy. Eur Urol. 2016;69:393–6.

    Article  PubMed  Google Scholar 

  20. Buskirk SJ, Pisansky TM, Schild SE, et al. Salvage radiotherapy for isolated prostate specific antigen increase after radical prostatectomy: evaluation of prognostic factors and creation of a prognostic scoring system. J Urol. 2006;176:985–90.

    Article  PubMed  Google Scholar 

  21. Canter D, Greenberg RE, Horwitz EM, et al. Implantation of electromagnetic transponders following radical prostatectomy for delivery of IMRT. Can J Urol. 2010;17:5365–9.

    PubMed  Google Scholar 

  22. Carrie C, Hasbini A, De Laroche G, et al. Interest of short hormonotherapy (HT) associated with radiotherapy (RT) as salvage treatment for biological relapse (BR) after radical prostatectomy (RP): results of the GETUG-AFU 16 phase III randomized trial. J Clin Oncol Meet Abst. 2015;33(Suppl):5006.

    Google Scholar 

  23. Castellucci P, Picchio M. 11C-choline PET/CT and PSA kinetics. Eur J Nucl Med Mol Imaging. 2013;40 Suppl 1:S36–40.

    Article  PubMed  CAS  Google Scholar 

  24. Chang JH, Park W, Park JS, et al. Significance of early prostate-specific antigen values after salvage radiotherapy in recurrent prostate cancer patients treated with surgery. Int J Urol. 2015;22:82–7.

    Article  CAS  PubMed  Google Scholar 

  25. Choo R, Danjoux C, Gardner S, et al. Efficacy of salvage radiotherapy plus 2-year androgen suppression for postradical prostatectomy patients with PSA relapse. Int J Radiat Oncol Biol Phys. 2009;75:983–9.

    Article  PubMed  Google Scholar 

  26. Coen JJ, Zietman AL, Thakral H, et al. Radical radiation for localized prostate cancer: local persistence of disease results in a late wave of metastases. J Clin Oncol. 2002;20:3199–205.

    Article  PubMed  Google Scholar 

  27. Connolly JA, Shinohara K, Presti Jr JC, et al. Local recurrence after radical prostatectomy: characteristics in size, location, and relationship to prostate-specific antigen and surgical margins. Urology. 1996;47:225–31.

    Article  CAS  PubMed  Google Scholar 

  28. Cooperberg MR, Davicioni E, Crisan A, et al. Combined value of validated clinical and genomic risk stratification tools for predicting prostate cancer mortality in a high-risk prostatectomy cohort. Eur Urol. 2015;67:326–33.

    Article  PubMed  Google Scholar 

  29. Corn BW, Winter K, Pilepich MV. Does androgen suppression enhance the efficacy of postoperative irradiation? A secondary analysis of RTOG 85-31. Radiation Therapy Oncology Group. Urology. 1999;54:495–502.

    Article  CAS  PubMed  Google Scholar 

  30. Croke J, Malone S, Roustan Delatour N, et al. Postoperative radiotherapy in prostate cancer: the case of the missing target. Int J Radiat Oncol Biol Phys. 2012;83:1160–8.

    Article  PubMed  Google Scholar 

  31. Da Pozzo LF, Cozzarini C, Briganti A, et al. 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. 2009;55:1003–11.

    Article  PubMed  Google Scholar 

  32. Eder M, Schäfer M, Bauder-Wüst U, et al. 68Ga-complex lipophilicity and the targeting property of a urea-based PSMA inhibitor for PET imaging. Bioconjug Chem. 2012;23:688–97.

    Article  CAS  PubMed  Google Scholar 

  33. Eiber M, Maurer T, Souvatzoglou M. Evaluation of hybrid 68Ga-PSMA ligand PET/CT in 248 patients with biochemical recurrence after radical prostatectomy. J Nucl Med. 2015;56:668–74.

    Article  PubMed  Google Scholar 

  34. Fiorino C, Foppiano F, Franzone P, et al. Rectal and bladder motion during conformal radiotherapy after radical prostatectomy. Radiother Oncol. 2005;74:187–95.

    Article  PubMed  Google Scholar 

  35. Ghadjar P, Hayoz S, Bernhard J, et al. Acute toxicity and quality of life after dose-intensified salvage radiation therapy for biochemically recurrent prostate cancer after prostatectomy: first results of the randomized trial SAKK 09/10. J Clin Oncol. 2015;33:4158–66.

    Article  CAS  PubMed  Google Scholar 

  36. Goenka A, Magsanoc JM, Pei X, et al. Improved toxicity profile following high-dose postprostatectomy salvage radiation therapy with intensity-modulated radiation therapy. Eur Urol. 2011;60:1142–8.

    Article  PubMed  Google Scholar 

  37. Hanlon AL, Horwitz EM, Hanks GE, et al. 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. 2004;58:43–52.

    Article  CAS  PubMed  Google Scholar 

  38. Heidenreich A, Bastian PJ, Bellmunt J, et al. EAU guidelines on prostate cancer. Part II: treatment of advanced, relapsing, and castration-resistant prostate cancer. Eur Urol. 2014;65:467–79.

    Article  CAS  PubMed  Google Scholar 

  39. Heinisch M, Dirisamer A, Loidl W, et al. Positron emission tomography/computed tomography with F-18-fluorocholine for restaging of prostate cancer patients: meaningful at PSA <5 ng/ml? Mol Imaging Biol. 2006;8:43–8.

    Article  PubMed  Google Scholar 

  40. Herlemann A, Wenter V, Kretschmer A, Thierfelder KM, Bartenstein P, Faber C, Gildehaus FJ, Stief CG, Gratzke C, Fendler WP. 68Ga-PSMA positron emission tomography/computed tomography provides accurate staging of lymph node regions prior to lymph node dissection in patients with prostate cancer. Eur Urol. 2016;pii: S0302-2838(16)00009-9.

    Google Scholar 

  41. Horwitz EM, Bae K, Hanks GE, et al. 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. 2008;26:2497–504.

    Article  CAS  PubMed  Google Scholar 

  42. Huch Boni RA, Meyenberger C, Pok Lundquist J, et al. Value of endorectal coil versus body coil MRI for diagnosis of recurrent pelvic malignancies. Abdom Imaging. 1996;21:345–52.

    Article  CAS  PubMed  Google Scholar 

  43. Jackson WC, Johnson SB, Foster B, et al. Combining prostate-specific antigen nadir and time to nadir allows for early identification of patients at highest risk for development of metastasis and death following salvage radiation therapy. Pract Radiat Oncol. 2014;4:99–107.

    Article  PubMed  Google Scholar 

  44. Kaminski JM, Hanlon AL, Joon DL, et al. Effect of sequencing of androgen deprivation and radiotherapy on prostate cancer growth. Int J Radiat Oncol Biol Phys. 2003;57:24–8.

    Article  CAS  PubMed  Google Scholar 

  45. Katz MS, Zelefsky MJ, Venkatraman ES, et al. Predictors of biochemical outcome with salvage conformal radiotherapy after radical prostatectomy for prostate cancer. J Clin Oncol. 2003;21:483–9.

    Article  PubMed  Google Scholar 

  46. Kibel AS, Ciezki JP, Klein EA, et al. Survival among men with clinically localized prostate cancer treated with radical prostatectomy or radiation therapy in the prostate specific antigen era. J Urol. 2012;187:1259–65.

    Article  PubMed  Google Scholar 

  47. King CR, Kapp DS. Radiotherapy after prostatectomy: is the evidence for dose escalation out there? Int J Radiat Oncol Biol Phys. 2008;71:346–50.

    Article  PubMed  Google Scholar 

  48. King CR, Presti Jr JC, Gill H, et al. Radiotherapy after radical prostatectomy: does transient androgen suppression improve outcomes? Int J Radiat Oncol Biol Phys. 2004;59:341–7.

    Article  PubMed  Google Scholar 

  49. Krause BJ, Souvatzoglou M, Tuncel M, et al. The detection rate of [11C]choline-PET/CT depends on the serum PSA-value in patients with biochemical recurrence of prostate cancer. Eur J Nucl Med Mol Imaging. 2008;35:18–23.

    Article  CAS  PubMed  Google Scholar 

  50. Kupelian PA, Langen KM, Willoughby TR, et al. Daily variations in the position of the prostate bed in patients with prostate cancer receiving postoperative external beam radiation therapy. Int J Radiat Oncol Biol Phys. 2006;66:593–6.

    Article  PubMed  Google Scholar 

  51. Leventis AK, Shariat SF, Slawin KM. Local recurrence after radical prostatectomy: correlation of US features with prostatic fossa biopsy findings. Radiology. 2001;219:432–9.

    Article  CAS  PubMed  Google Scholar 

  52. Lohm G, Lütcke J, Jamil B, et al. Salvage radiotherapy in patients with prostate cancer and biochemical relapse after radical prostatectomy: long-term follow-up of a single-center survey. Strahlenther Onkol. 2014;190:727–31.

    Article  PubMed  Google Scholar 

  53. Michalski JM, Lawton C, El Naqa I, et al. 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. 2010;76:361–8.

    Article  PubMed  Google Scholar 

  54. Michalski JM, Roach 3rd M, Merrick G, et al. ACR appropriateness criteria on external beam radiation therapy treatment planning for clinically localized prostate cancer expert panel on radiation oncology – prostate. Int J Radiat Oncol Biol Phys. 2009;74:667–72.

    Article  PubMed  Google Scholar 

  55. Mir MC, Li J, Klink JC, et al. Optimal definition of biochemical recurrence after radical prostatectomy depends on pathologic risk factors: identifying candidates for early salvage therapy. Eur Urol. 2014;66:204–10.

    Article  PubMed  Google Scholar 

  56. Miralbell R, Vees H, Lozano J, et al. Endorectal MRI assessment of local relapse after surgery for prostate cancer: a model to define treatment field guidelines for adjuvant radiotherapy in patients at high risk for local failure. Int J Radiat Oncol Biol Phys. 2007;67:356–61.

    Article  PubMed  Google Scholar 

  57. Moinpour CM, Hayden KA, Unger JM, et al. Health-related quality of life results in pathologic stage C prostate cancer from a Southwest Oncology Group trial comparing radical prostatectomy alone with radical prostatectomy plus radiation therapy. J Clin Oncol. 2008;26:112–20.

    Article  PubMed  Google Scholar 

  58. Moreira DM, Jayachandran J, Presti Jr JC, et al. Validation of a nomogram to predict disease progression following salvage radiotherapy after radical prostatectomy: results from the SEARCH database. BJU Int. 2009;104:1452–6.

    Article  PubMed  Google Scholar 

  59. Nath SK, Sandhu AP, Rose BS, et al. Toxicity analysis of postoperative image-guided intensity-modulated radiotherapy for prostate cancer. Int J Radiat Oncol Biol Phys. 2010;78:435–41.

    Article  PubMed  Google Scholar 

  60. Naya Y, Okihara K, Evans RB, et al. Efficacy of prostatic fossa biopsy in detecting local recurrence after radical prostatectomy. Urology. 2005;66:350–5.

    Article  PubMed  Google Scholar 

  61. Neuhof D, Hentschel T, Bischof M, et al. Long-term results and predictive factors of three-dimensional conformal salvage radiotherapy for biochemical relapse after prostatectomy. Int J Radiat Oncol Biol Phys. 2007;67:1411–7.

    Article  PubMed  Google Scholar 

  62. Ohri N, Dicker AP, Trabulsi EJ, et al. Can early implementation of salvage radiotherapy for prostate cancer improve the therapeutic ratio? A systematic review and regression meta-analysis with radiobiological modelling. Eur J Cancer. 2012;48:837–44.

    Article  PubMed  Google Scholar 

  63. Ost P, De Gersem W, De Potter B, et al. A comparison of the acute toxicity profile between two-dimensional and three-dimensional image-guided radiotherapy for postoperative prostate cancer. Clin Oncol (R Coll Radiol). 2011;23:344–9.

    Article  CAS  Google Scholar 

  64. Ost P, De Meerleer G, Vercauteren T, et al. Delineation of the postprostatectomy prostate bed using computed tomography: interobserver variability following the EORTC delineation guidelines. Int J Radiat Oncol Biol Phys. 2011;81:e143–9.

    Article  PubMed  Google Scholar 

  65. Ost P, De Troyer B, Fonteyne V, et al. A matched control analysis of adjuvant and salvage high-dose postoperative intensity-modulated radiotherapy for prostate cancer. Int J Radiat Oncol Biol Phys. 2011;80:1316–22.

    Article  PubMed  Google Scholar 

  66. Ost P, Lumen N, Goessaert AS, et al. High-dose salvage intensity-modulated radiotherapy with or without androgen deprivation after radical prostatectomy for rising or persisting prostate-specific antigen: 5-year results. Eur Urol. 2011;60:842–9.

    Article  PubMed  Google Scholar 

  67. Panebianco V, Sciarra A, Lisi D, et al. Prostate cancer: 1HMRS-DCEMR at 3T versus [(18)F]choline PET/CT in the detection of local prostate cancer recurrence in men with biochemical progression after radical retropubic prostatectomy. Eur J Radiol. 2012;81:700–8.

    Article  PubMed  Google Scholar 

  68. Parker C, Sydes MR, Catton C, et al. 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. 2007;99:1376–9.

    Article  PubMed  CAS  Google Scholar 

  69. Paskalev K, Feigenberg S, Jacob R, et al. Target localization for post-prostatectomy patients using CT and ultrasound image guidance. J Appl Clin Med Phys. 2005;6:40–9.

    Article  PubMed  Google Scholar 

  70. Pazona JF, Han M, Hawkins SA, et al. Salvage radiation therapy for prostate specific antigen progression following radical prostatectomy: 10-year outcome estimates. J Urol. 2005;174(4 Pt 1):1282–6.

    Article  PubMed  Google Scholar 

  71. Pinkawa M, Siluschek J, Gagel B, et al. Postoperative radiotherapy for prostate cancer: evaluation of target motion and treatment techniques (intensity-modulated versus conformal radiotherapy). Strahlenther Onkol. 2007;183:23–9.

    Article  PubMed  Google Scholar 

  72. Pisansky TM, Kozelsky TF, Myers RP, et al. Radiotherapy for isolated serum prostate specific antigen elevation after prostatectomy for prostate cancer. J Urol. 2000;163:845–50.

    Article  CAS  PubMed  Google Scholar 

  73. Poortmans P, Bossi A, Vandeputte K, et al. Guidelines for target volume definition in post-operative radiotherapy for prostate cancer, on behalf of the EORTC Radiation Oncology Group. Radiother Oncol. 2007;84:121–7.

    Article  PubMed  Google Scholar 

  74. Rossi Jr CJ, Joe Hsu IC, Abdel-Wahab M, et al. ACR appropriateness criteria postradical prostatectomy irradiation in prostate cancer. Am J Clin Oncol. 2011;34:92–8.

    Article  PubMed  Google Scholar 

  75. Sandhu A, Sethi R, Rice R, et al. Prostate bed localization with image-guided approach using on-board imaging: reporting acute toxicity and implications for radiation therapy planning following prostatectomy. Radiother Oncol. 2008;88:20–5.

    Article  PubMed  Google Scholar 

  76. Scattoni V, Montorsi F, Picchio M, et al. Diagnosis of local recurrence after radical prostatectomy. BJU Int. 2004;93:680–8.

    Article  CAS  PubMed  Google Scholar 

  77. Schiffner DC, Gottschalk AR, Lometti M, et al. Daily electronic portal imaging of implanted gold seed fiducials in patients undergoing radiotherapy after radical prostatectomy. Int J Radiat Oncol Biol Phys. 2007;67:610–9.

    Article  PubMed  Google Scholar 

  78. Sella T, Schwartz LH, Swindle PW, et al. Suspected local recurrence after radical prostatectomy: endorectal coil MR imaging. Radiology. 2004;231:379–85.

    Article  PubMed  Google Scholar 

  79. Shariat SF, Karakiewicz PI, Roehrborn CG, et al. An updated catalog of prostate cancer predictive tools. Cancer. 2008;113:3075–99.

    Article  PubMed  Google Scholar 

  80. Shekarriz B, Upadhyay J, Wood Jr DP, et al. Vesicourethral anastomosis biopsy after radical prostatectomy: predictive value of prostate-specific antigen and pathologic stage. Urology. 1999;54:1044–8.

    Article  CAS  PubMed  Google Scholar 

  81. Shipley WU, Pugh SL, Lukka HR, et al. NRG Oncology/RTOG 9601, a phase III trial in prostate cancer patients: anti-androgen therapy (AAT) with bicalutamide during and after salvage radiation therapy following radical prostatectomy and an elevated PSA. J Clin Oncol. 2016;34:(suppl 2S; abstr 3).

    Google Scholar 

  82. Shipley WU, Seiferheld W, Lukka H, et al. Report of NRG oncology/RTOG 9601, a phase III trial in prostate cancer: anti-androgen therapy (AAT) with bicalutamide during and after radiation therapy (RT) in patients following radical prostatectomy (RP) with pT2-3pN0 disease and an elevated PSA. ASTRO meeting: Abstract LBA5; 2015.

    Google Scholar 

  83. Showalter TN, Nawaz AO, Xiao Y, et al. A cone beam CT-based study for clinical target definition using pelvic anatomy during postprostatectomy radiotherapy. Int J Radiat Oncol Biol Phys. 2008;70:431–6.

    Article  PubMed  Google Scholar 

  84. Sidhom MA, Kneebone AB, Lehman M, et al. Post-prostatectomy radiation therapy: consensus guidelines of the Australian and New Zealand Radiation Oncology Genito-Urinary Group. Radiother Oncol. 2008;88:10–9.

    Article  PubMed  Google Scholar 

  85. Siegmann A, Bottke D, Faehndrich J, et al. 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. 2011;187:467–72.

    Article  PubMed  Google Scholar 

  86. Silver DA, Pellicer I, Fair WR, et al. Prostate-specific membrane antigen expression in normal and malignant human tissues. Clin Cancer Res. 1997;3:81–5.

    CAS  PubMed  Google Scholar 

  87. Soto DE, Passarelli MN, Daignault S, et al. Concurrent androgen deprivation therapy during salvage prostate radiotherapy improves treatment outcomes in high-risk patients. Int J Radiat Oncol Biol Phys. 2011;82:1227–32.

    Article  PubMed  PubMed Central  Google Scholar 

  88. 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. 2007;69:54–61.

    Article  PubMed  Google Scholar 

  89. Stamey TA, Yang N, Hay AR, et al. Prostate-specific antigen as a serum marker for adenocarcinoma of the prostate. N Engl J Med. 1987;317:909–16.

    Article  CAS  PubMed  Google Scholar 

  90. Stephenson AJ, Bolla M, Briganti A, et al. Postoperative radiation therapy for pathologically advanced prostate cancer after radical prostatectomy. Eur Urol. 2012;61:443–51.

    Article  PubMed  Google Scholar 

  91. Stephenson AJ, Scardino PT, Kattan MW, et al. Predicting the outcome of salvage radiation therapy for recurrent prostate cancer after radical prostatectomy. J Clin Oncol. 2007;25:2035–41.

    Article  PubMed  PubMed Central  Google Scholar 

  92. Stephenson AJ, Shariat SF, Zelefsky MJ, et al. Salvage radiotherapy for recurrent prostate cancer after radical prostatectomy. JAMA. 2004;291:1325–32.

    Article  CAS  PubMed  Google Scholar 

  93. Stephenson AJ, Wood DP, Kattan MW, et al. Location, extent and number of positive surgical margins do not improve accuracy of predicting prostate cancer recurrence after radical prostatectomy. J Urol. 2009;182:1357–63.

    Article  PubMed  Google Scholar 

  94. Sweat SD, Pacelli A, Murphy GP, et al. Prostate-specific membrane antigen expression is greatest in prostate adenocarcinoma and lymph node metastases. Urology. 1998;52:637–40.

    Article  CAS  PubMed  Google Scholar 

  95. Taylor N, Kelly JF, Kuban DA, et al. Adjuvant and salvage radiotherapy after radical prostatectomy for prostate cancer. Int J Radiat Oncol Biol Phys. 2003;56:755–63.

    Article  CAS  PubMed  Google Scholar 

  96. Thompson Jr IM, Tangen CM, Paradelo J, et al. Adjuvant radiotherapy for pathologically advanced prostate cancer: a randomized clinical trial. JAMA. 2006;296:2329–35.

    Article  CAS  PubMed  Google Scholar 

  97. Thompson IM, Tangen CM, Paradelo J, et al. 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. 2009;181:956–62.

    Article  PubMed  PubMed Central  Google Scholar 

  98. Thompson IM, Valicenti RK, Albertsen P, et al. Adjuvant and salvage radiotherapy after prostatectomy: AUA/ASTRO guideline. J Urol. 2013;190:441–9.

    Article  PubMed  Google Scholar 

  99. Tilki D, Mandel P, Schlomm T, et al. External validation of the CAPRA-S score to predict biochemical recurrence, metastasis and mortality after radical prostatectomy in a European cohort. J Urol. 2015;193:1970–5.

    Article  PubMed  Google Scholar 

  100. Trabulsi EJ, Valicenti RK, Hanlon AL, et al. A multi-institutional matched-control analysis of adjuvant and salvage postoperative radiation therapy for pT3-4N0 prostate cancer. Urology. 2008;72:1298–302; discussion 1302–1294.

    Article  PubMed  PubMed Central  Google Scholar 

  101. Trock BJ, Han M, Freedland SJ, et al. Prostate cancer-specific survival following salvage radiotherapy vs observation in men with biochemical recurrence after radical prostatectomy. JAMA. 2008;299:2760–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  102. Van der Kwast TH, Bolla M, van Poppel H, et al. Identification of patients with prostate cancer who benefit from immediate postoperative radiotherapy: EORTC 22911. J Clin Oncol. 2007;25:4178–86.

    Article  PubMed  Google Scholar 

  103. Wang J, Kudchadker R, Choi S, et al. Local recurrence map to guide target volume delineation after radical prostatectomy. Pract Radiat Oncol. 2014;4:e239–46.

    Article  PubMed  Google Scholar 

  104. Ward JF, Zincke H, Bergstralh EJ, et al. Prostate specific antigen doubling time subsequent to radical prostatectomy as a prognosticator of outcome following salvage radiotherapy. J Urol. 2004;172(6 Pt 1):2244–8.

    Article  PubMed  Google Scholar 

  105. Wenz F, Martin T, Böhmer D, et al. The German S3 guideline prostate cancer: aspects for the radiation oncologist. Strahlenther Onkol. 2010;186:531–4.

    Article  PubMed  Google Scholar 

  106. Wiegel T, Bartkowiak D, Bottke D. Adjuvant radiotherapy versus wait-and-see after radical prostatectomy: 10-year follow-up of the ARO 96-02/AUO AP 09/95 trial. Eur Urol. 2014;66:243–50.

    Article  PubMed  Google Scholar 

  107. Wiegel T, Bartkowiak D, Bottke D. Prostate-specific antigen persistence after radical prostatectomy as a predictive factor of clinical relapse-free survival and overall survival: 10-year data of the ARO 96–02 trial. Int J Radiat Oncol Biol Phys. 2015;91:288–94.

    Article  PubMed  Google Scholar 

  108. Wiegel T, Bottke D, Steiner U, et al. 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. 2009;27:2924–30.

    Article  PubMed  Google Scholar 

  109. Wiegel T, Lohm G, Bottke D, et al. 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. 2009;73:1009–16.

    Article  PubMed  Google Scholar 

  110. Wieser G, Mansi R, Grosu AL, et al. Positron emission tomography (PET) imaging of prostate cancer with a gastrin releasing peptide receptor antagonist-from mice to men. Theranostics. 2014;4:412–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  111. Wiltshire KL, Brock KK, Haider MA, et al. Anatomic boundaries of the clinical target volume (prostate bed) after radical prostatectomy. Int J Radiat Oncol Biol Phys. 2007;69:1090–9.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Radiotherapy and Radiation Oncology, MVZ (Medical Service Center) Klinikum Esslingen GmbH, Hirschlandstraße 97, 73730, Esslingen, Germany

    Dirk Bottke

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

    Detlef Bartkowiak & Thomas Wiegel

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  1. Dirk Bottke
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  2. Detlef Bartkowiak
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  3. Thomas Wiegel
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Correspondence to Dirk Bottke .

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Editors and Affiliations

  1. Department of Radiation Oncology, Hôpital Albert Michallon, Grenoble, France

    Michel Bolla

  2. Department of Urology, University Hospitals Leuven, Leuven, Belgium

    Hendrik van Poppel

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Bottke, D., Bartkowiak, D., Wiegel, T. (2017). Postoperative Irradiation: Immediate or Early Delayed?. In: Bolla, M., van Poppel, H. (eds) Management of Prostate Cancer. Springer, Cham. https://doi.org/10.1007/978-3-319-42769-0_16

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  • DOI: https://doi.org/10.1007/978-3-319-42769-0_16

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