title: Cancer control and complications of salvage local therapy after failure of radiotherapy for prostate cancer: a systematic review.
abstract: The National Comprehensive Cancer Network guidelines currently endorse salvage local therapy as a reasonable alternative to observation or androgen-deprivation therapy for select men with a biopsy-proven local recurrence after definitive radiation for prostate cancer. Patients being considered for salvage therapy should have had localized disease at presentation, a prostate-specific antigen < 10 at recurrence, a life expectancy >10 years at recurrence, and a negative metastatic workup. In this systematic review, we synthesize the current literature describing the oncologic efficacy and toxicity profile of salvage brachytherapy, prostatectomy, cryotherapy, and high-intensity focused ultrasound. We found 5-year biochemical control rates to be similar across treatments, in the range of 52%-56%, although patient selection and definition of failure was variable. Toxicity profiles were also distinct between local salvage modalities.
authors.affiliation: Department of Radiation Oncology, Dana-Farber/Brigham and Women's Cancer Center, Harvard Medical School, Boston, MA 02115, USA.
authors.forename: Arti
authors.initials: A
authors.lastname: Parekh
authors.forename: Powell L
authors.initials: PL
authors.lastname: Graham
authors.forename: Paul L
authors.initials: PL
authors.lastname: Nguyen
mesh_terms: D001918:Brachytherapy / Q000379:methods*; D017679:Cryotherapy / Q000379:methods; D055356:Endometrial Ablation Techniques / Q000379:methods*; D057086:High-Intensity Focused Ultrasound Ablation / Q000379:methods; D006801:Humans; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000601:surgery / Q000628:therapy*; D018579:Patient Selection; D011468:Prostatectomy / Q000379:methods*; D011471:Prostatic Neoplasms / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D016879:Salvage Therapy / Q000379:methods*; D016896:Treatment Outcome