Locally ablative therapies for primary radiation failures: a review and critical assessment of the efficacy.
A significant number of men with prostate cancer will experience biochemical failure following treatment with primary radiation therapy. For patients with biopsy-proven recurrent cancer confined to the prostate, local salvage therapy may be a potentially curative treatment option. Most men, however, do not undergo local salvage therapy owing to difficulties in diagnosis as well as concerns over treatment-related complications in the salvage setting. Recently, improvements in technique and technology have substantially reduced the morbidity associated with locally ablative therapies, resulting in an increased interest in the use of minimally invasive therapies such as brachytherapy, cryotherapy, and high-intensity focused ultrasound in the salvage setting. Although these treatments are well tolerated, concerns remain over incomplete and inadequate treatment with locally ablative therapies. Future studies are required to appropriately select candidates for salvage ablative therapies and to determine the long-term oncologic efficacy of these treatments.
Huang
William C
WC
Sidney Kimmel Center for Prostate and Urologic Cancers, Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA.
Lee
Courtney L
CL
Eastham
James A
JA
D001918:Brachytherapy; D017679:Cryotherapy; D006801:Humans; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000628:therapy*; D011471:Prostatic Neoplasms / Q000532:radiotherapy* / Q000628:therapy; D016879:Salvage Therapy; D017211:Treatment Failure; D016896:Treatment Outcome; D014464:Ultrasonic Therapy