title: Adjuvant and salvage radiation therapy after prostatectomy: American Society for Radiation Oncology/American Urological Association guidelines.
abstract: OBJECTIVE
  The purpose of this guideline was to provide a clinical framework for the use of radiation therapy after radical prostatectomy as adjuvant or salvage therapy.
  
  
  METHODS
  A systematic literature review using PubMed, Embase, and Cochrane database was conducted to identify peer-reviewed publications relevant to the use of radiation therapy after prostatectomy. The review yielded 294 articles; these publications were used to create the evidence-based guideline statements. Additional guidance is provided as Clinical Principles when insufficient evidence existed.
  
  
  RESULTS
  Guideline statements are provided for patient counseling, use of radiation therapy in the adjuvant and salvage contexts, defining biochemical recurrence, and conducting a restaging evaluation.
  
  
  CONCLUSIONS
  Physicians should offer adjuvant radiation therapy to patients with adverse pathologic findings at prostatectomy (ie, seminal vesicle invastion, positive surgical margins, extraprostatic extension) and salvage radiation therapy to patients with prostate-specific antigen (PSA) or local recurrence after prostatectomy in whom there is no evidence of distant metastatic disease. The offer of radiation therapy should be made in the context of a thoughtful discussion of possible short- and long-term side effects of radiation therapy as well as the potential benefits of preventing recurrence. The decision to administer radiation therapy should be made by the patient and the multidisciplinary treatment team with full consideration of the patient's history, values, preferences, quality of life, and functional status. The American Society for Radiation Oncology and American Urological Association websites show this guideline in its entirety, including the full literature review.
authors.affiliation: Department of Radiation Oncology, University of California, Davis School of Medicine, Davis, California, USA. Richard.valicenti@ucdmc.ucdavis.edu
authors.forename: Richard K
authors.initials: RK
authors.lastname: Valicenti
authors.forename: Ian
authors.initials: I
authors.lastname: Thompson
authors.forename: Peter
authors.initials: P
authors.lastname: Albertsen
authors.forename: Brian J
authors.initials: BJ
authors.lastname: Davis
authors.forename: S Larry
authors.initials: SL
authors.lastname: Goldenberg
authors.forename: J Stuart
authors.initials: JS
authors.lastname: Wolf
authors.forename: Oliver
authors.initials: O
authors.lastname: Sartor
authors.forename: Eric
authors.initials: E
authors.lastname: Klein
authors.forename: Carol
authors.initials: C
authors.lastname: Hahn
authors.forename: Jeff
authors.initials: J
authors.lastname: Michalski
authors.forename: Mack
authors.initials: M
authors.lastname: Roach
authors.forename: Martha M
authors.initials: MM
authors.lastname: Faraday
mesh_terms: D006801:Humans; D008297:Male; D010353:Patient Education as Topic / Q000592:standards; D017430:Prostate-Specific Antigen / Q000097:blood; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000532:radiotherapy*; D018787:Radiation Oncology / Q000592:standards*; D018714:Radiotherapy, Adjuvant / Q000009:adverse effects / Q000592:standards*; D016879:Salvage Therapy / Q000009:adverse effects / Q000592:standards*; D012955:Societies, Medical; D014481:United States; D014572:Urology / Q000592:standards*
chemical_list: D017430:Prostate-Specific Antigen