title: [Postoperative radiotherapy of prostate cancer].
abstract: Between 10 and 40% of patients who have undergone a radical prostatectomy may have a biologic recurrence. Local or distant failure represents the possible patterns of relapse. Patients at high-risk for local relapse have extraprostatic disease, positive surgical margins or seminal vesicles infiltration or high Gleason score at pathology. Three phase-III randomized clinical trials have shown that, for these patients, adjuvant irradiation reduces the risk of tumoral progression without higher toxicity. Salvage radiotherapy for late relapse allows a disease control in 60-70% of the cases. Several research in order to improve the therapeutic ratio of the radiotherapy after prostatectomy are evaluate in the French Groupe d'Étude des Tumeurs Urogénitales (Gétug) and of the French association of urology (Afu). The Gétug-Afu 17 trial will provide answers to the question of the optimal moment for postoperative radiotherapy for pT3-4 R1 pN0 Nx patients, with the objective of comparing an immediate treatment to a differed early treatment initiated at biological recurrence. The Gétug-Afu 22 questions the place of a short hormonetherapy combined with image-guided, intensity-modulated radiotherapy (IMRT) in adjuvant situation for a detectable prostate specific antigen (PSA). The implementation of a multicenter quality control within the Gétug-Afu in order to harmonize a modern postoperative radiotherapy will allow the development of a dose escalation IMRT after surgery.
authors.affiliation: Service de radiothérapie, pôle régional de cancérologie, CHU de Poitiers, 350, avenue Jacques-Cœur, 86000 Poitiers, France. Electronic address: stephane.guerif@chu-poitiers.fr.
authors.forename: S
authors.initials: S
authors.lastname: Guérif
authors.affiliation: Service de radiothérapie, groupe Oncorad Garonne, clinique Pasteur, « L'Atrium », 1, rue de la Petite-Vitesse, 31300 Toulouse, France.
authors.forename: I
authors.initials: I
authors.lastname: Latorzeff
authors.affiliation: Service de radiothérapie, hôpital Henri-Mondor, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil cedex, France.
authors.forename: J-L
authors.initials: JL
authors.lastname: Lagrange
authors.affiliation: Service de radiothérapie, hôpital Saint-Louis, 1, avenue Claude-Vellefeaux, 75475 Paris cedex, France.
authors.forename: C
authors.initials: C
authors.lastname: Hennequin
authors.affiliation: Service de radiothérapie, institut de cancérologie de l'Ouest, centre René-Gauducheau, boulevard Jacques-Monod, 44805 Saint-Herblain, France.
authors.forename: S
authors.initials: S
authors.lastname: Supiot
authors.affiliation: UF radiophysique, pôle régional de cancérologie, CHU de Poitiers, 350, avenue Jacques-Cœur, 86000 Poitiers, France.
authors.forename: A
authors.initials: A
authors.lastname: Garcia
authors.affiliation: UF radiophysique, pôle régional de cancérologie, CHU de Poitiers, 350, avenue Jacques-Cœur, 86000 Poitiers, France.
authors.forename: P
authors.initials: P
authors.lastname: François
authors.affiliation: Service d'urologie, CHU Rangueil, 1, avenue du Pr-Jean-Poulhès, 31400 Toulouse, France.
authors.forename: M
authors.initials: M
authors.lastname: Soulié
authors.affiliation: Service de radiothérapie, centre régional de lutte contre le cancer, institut Bergonié, 229, cours de l'Argonne, 33076 Bordeaux, France.
authors.forename: P
authors.initials: P
authors.lastname: Richaud
authors.affiliation: Service d'urologie, CHU Henri-Mondor, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil cedex, France.
authors.forename: L
authors.initials: L
authors.lastname: Salomon
mesh_terms: D000230:Adenocarcinoma / Q000097:blood / Q000188:drug therapy / Q000532:radiotherapy* / Q000556:secondary / Q000601:surgery; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use; D017326:Clinical Trials, Phase III as Topic; D003131:Combined Modality Therapy; D019583:Dose Fractionation, Radiation; D006801:Humans; D015182:Lymphatic Irradiation; D008207:Lymphatic Metastasis / Q000532:radiotherapy; D008297:Male; D015337:Multicenter Studies as Topic; D064847:Multimodal Imaging; D009364:Neoplasm Recurrence, Local / Q000097:blood / Q000532:radiotherapy; D011182:Postoperative Care; D017430:Prostate-Specific Antigen / Q000097:blood; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000097:blood / Q000188:drug therapy / Q000532:radiotherapy* / Q000601:surgery; D011786:Quality Control; D011879:Radiotherapy Dosage; D018714:Radiotherapy, Adjuvant / Q000379:methods*; D061089:Radiotherapy, Image-Guided; D050397:Radiotherapy, Intensity-Modulated; D016879:Salvage Therapy / Q000379:methods
chemical_list: D018931:Antineoplastic Agents, Hormonal; D017430:Prostate-Specific Antigen
keywords: Adjuvant treatment; Cancer de la prostate; Postoperative radiotherapy; Prostate cancer; Radiothérapie postopératoire; Salvage treatment; Traitement adjuvant; Traitement de rattrapage