Salvage Therapy for Prostate Cancer: AUA/ASTRO/SUO Guideline Part II: Treatment Delivery for Non-Metastatic Biochemical Recurrence After Primary Radical Prostatectomy
February 2024
in “
The Journal of Urology
”
TLDR Adding hormone therapy to radiation improves survival for high-risk prostate cancer recurrence but has side effects.
The guideline recommends combining androgen deprivation therapy (ADT) with salvage radiation therapy (RT) for patients with non-metastatic biochemical recurrence (BCR) after radical prostatectomy (RP) who have high-risk features, supported by three randomized trials involving over 2,600 patients. This combination improves progression-free survival, metastasis-free survival, and overall survival in certain subgroups. For patients without high-risk features, salvage RT alone may suffice. The addition of ADT can increase side effects, necessitating a shared decision-making approach. The guideline also advises against adding docetaxel to salvage RT and ADT due to lack of benefit and increased toxicity, and recommends intensified androgen receptor suppression only within clinical trials.
