Salvage therapy for prostate cancer after radical prostatectomy.
Adenocarcinoma
/ pathology
Androgen Antagonists
/ therapeutic use
Dose Fractionation, Radiation
Humans
Kallikreins
/ blood
Male
Neoplasm Grading
Neoplasm Recurrence, Local
/ blood
Positron-Emission Tomography
Prostate-Specific Antigen
/ blood
Prostatectomy
Prostatic Neoplasms
/ pathology
Radiotherapy
/ methods
Salvage Therapy
/ methods
Journal
Nature reviews. Urology
ISSN: 1759-4820
Titre abrégé: Nat Rev Urol
Pays: England
ID NLM: 101500082
Informations de publication
Date de publication:
11 2021
11 2021
Historique:
accepted:
18
06
2021
pubmed:
8
8
2021
medline:
29
1
2022
entrez:
7
8
2021
Statut:
ppublish
Résumé
More than 40% of men with intermediate-risk or high-risk prostate cancer will experience a biochemical recurrence after radical prostatectomy. Clinical guidelines for the management of these patients largely focus on the use of salvage radiotherapy with or without systemic therapy. However, not all patients with biochemical recurrence will go on to develop metastases or die from their disease. The optimal pre-salvage therapy investigational workup for patients who experience biochemical recurrence should, therefore, include novel techniques such as PET imaging and genomic analysis of radical prostatectomy specimen tissue, as well as consideration of more traditional clinical variables such as PSA value, PSA kinetics, Gleason score and pathological stage of disease. In patients without metastatic disease, the only known curative intervention is salvage radiotherapy but, given the therapeutic burden of this treatment, importance must be placed on accurate timing of treatment, radiation dose, fractionation and field size. Systemic therapy also has a role in the salvage setting, both concurrently with radiotherapy and as salvage monotherapy.
Identifiants
pubmed: 34363040
doi: 10.1038/s41585-021-00497-7
pii: 10.1038/s41585-021-00497-7
doi:
Substances chimiques
Androgen Antagonists
0
KLK3 protein, human
EC 3.4.21.-
Kallikreins
EC 3.4.21.-
Prostate-Specific Antigen
EC 3.4.21.77
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
643-668Subventions
Organisme : NCI NIH HHS
ID : L30 CA231572-01
Pays : United States
Informations de copyright
© 2021. Springer Nature Limited.
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