[Salvage radiotherapy after prostatectomy - what do do in case of elevated post operative PSA or macroscopic relapse?]

Abstract

The management of the postoperative biological relapse of prostate cancer is most often based on salvage radiotherapy (RT) and a variable duration of hormone therapy (HT) in addition. The indications for RT±HT become more consensual for the adjuvant postoperative situation or in the event of a rising PSA level after a period where an undetectable PSA level was achieved. On the other hand, in the event of detectable PSA immediately postoperatively or in the event of a biological recurrence with macroscopic relapse in the prostate bed seen on conventional imaging assessment, the treatment options are still being evaluated. This article will describe these 2 situations and their current management but also will come through assessments with the contribution of modern imaging and new treatment options in terms of RT dose and RT±HT combination.

Keywords: Cancer de la prostate; Clinical trials; Detectable PSA; Essais cliniques; Macroscopic relapse; PSA détectable; Prostate cancer; Radiothérapie de rattrapage; Rechute macroscopique; Salvage radiation therapy.