Cancer Control and Complications of Salvage Local Therapy After Failure of Radiotherapy for Prostate Cancer: A Systematic Review

• Published in: Seminars in radiation oncology Vol. 23; no. 3; pp. 222 - 234
• Main Authors: Parekh, Arti, BA, Graham, Powell L., AB, Nguyen, Paul L., MD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-07-2013
• Subjects: Brachytherapy - methods; Cryotherapy - methods; Endometrial Ablation Techniques - methods; Hematology, Oncology and Palliative Medicine; High-Intensity Focused Ultrasound Ablation - methods; Humans; Male; Neoplasm Recurrence, Local - surgery; Neoplasm Recurrence, Local - therapy; Patient Selection; Prostatectomy - methods; Prostatic Neoplasms - radiotherapy; Prostatic Neoplasms - surgery; Prostatic Neoplasms - therapy; Radiology; Salvage Therapy - methods; Treatment Outcome
• ISSN: 1053-4296; 1532-9461
• DOI: 10.1016/j.semradonc.2013.01.006

The National Comprehensive Cancer Network guidelines currently endorse salvage local therapy as a reasonable alternative to observation or androgen-deprivation therapy for select men with a biopsy-proven local recurrence after definitive radiation for prostate cancer. Patients being considered for salvage therapy should have had localized disease at presentation, a prostate-specific antigen < 10 at recurrence, a life expectancy >10 years at recurrence, and a negative metastatic workup. In this systematic review, we synthesize the current literature describing the oncologic efficacy and toxicity profile of salvage brachytherapy, prostatectomy, cryotherapy, and high-intensity focused ultrasound. We found 5-year biochemical control rates to be similar across treatments, in the range of 52%-56%, although patient selection and definition of failure was variable. Toxicity profiles were also distinct between local salvage modalities.