Statement 9: Clinicians should offer hormonal therapy with radiotherapy to patients who are candidates for salvage radiation therapy. Ongoing research may someday allow personalized selection of hormonal or other therapies within patient subsets.
In addition to the guideline statements, new information related to genomic classifiers, as predictors of treatment effectiveness, was added to the guideline future research needs. Further study in this area is needed to determine whether a genomic classifier is predictive of outcomes in a yet to be treated patient, and whether it is predictive for efficacy of a particular treatment.
"Evidence from three, well-established randomized trials now confirm significant improvements in biochemical recurrence-free survival among patients with adverse pathological features with the use of adjuvant radiotherapy," said Ian Thompson, MD, co-chair of the guideline panel and professor and chairman of the urology division at the University of Texas Health Sciences Center at San Antonio, Texas. "Our expectation is this guideline is fully aligned to the latest science and provides physicians with a relevant blueprint for the use of radiotherapy after prostatectomy."
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"As research in prostate cancer evolves and improves, data continue to accumulate in support of radiotherapy following radical prostatectomy. We now know that radiotherapy and the combination of hormone therapy with radiation, following radical prostatectomy, have contributed to even more favorable outcomes for patients than seen previously," said Richard K. Valicenti, MD, FASTRO, co-chair of the guideline panel and professor and chairman of radiation oncology at the University of California-Davis Comprehensive Cancer Center in Sacramento, California. "With the current update, this collaborative guideline now reflects nearly three decades of multidisciplinary research."
The full text of the amended evidence-based Adjuvant and Salvage Radiotherapy after Prostatectomy Guideline is now available online in the Journal of Urology and in Practical Radiation Oncology.
Authors of this Amendment included Thomas M. Pisansky, MD, Ian M. Thompson, MD, Richard K. Valicenti, MD, Anthony V. D'Amico, MD, Shalini Selvarajah, MD, MPH.
About ASTRO:
The American Society for Radiation Oncology (ASTRO) is the world's largest radiation oncology society, with more than 10,000 members who are physicians, nurses, biologists, physicists, radiation therapists, dosimetrists and other health care professionals who specialize in treating patients with radiation therapies. The Society is dedicated to improving patient care through professional education and training, support for clinical practice and health policy standards, advancement of science and research, and advocacy.
