title: Role of Dose Intensification for Salvage Radiation Therapy after Radical Prostatectomy.
abstract: For primary radiation therapy (RT) of prostate cancer, dose intensification is established as standard of care. Less is known on the role of dose intensification in the postprostatectomy setting for salvage RT. Thus, we aimed to identify and summarize the existing literature. In retrospective analyses, dose-intensified salvage RT showed a superior biochemical control compared to standard dose salvage radiation with favorable acute and late gastrointestinal and genitourinary toxicity rates, especially when modern radiation techniques such as intensity modulated RT were applied. We identified one randomized phase III trial addressing the potential benefits of dose-intensified salvage RT (SAKK 09/10). Recently, acute gastrointestinal and genitourinary toxicities and early quality of life data of this trial were reported, and no significant difference in acute toxicities between both treatment arms were found; however, a significant worsening of genitourinary quality of life was noted in the dose-intensified treatment arm. Whereas dose-intensified salvage RT appears to be feasible and well tolerated, the improved biochemical control rates using dose intensified RT as suggested by retrospective analyses have yet to be validated by prospective trials.
authors.affiliation: Department of Radiation Oncology, Charité Universitätsmedizin Berlin , Berlin , Germany.
authors.forename: Marcus
authors.initials: M
authors.lastname: Beck
authors.affiliation: Department of Radiation Oncology, Charité Universitätsmedizin Berlin , Berlin , Germany.
authors.forename: Tomasz
authors.initials: T
authors.lastname: Barelkowski
authors.affiliation: Department of Radiation Oncology, Charité Universitätsmedizin Berlin , Berlin , Germany.
authors.forename: David
authors.initials: D
authors.lastname: Kaul
authors.affiliation: Department of Radiation Oncology, Charité Universitätsmedizin Berlin , Berlin , Germany.
authors.forename: Sascha
authors.initials: S
authors.lastname: Wecker
authors.affiliation: Department of Radiation Oncology, Charité Universitätsmedizin Berlin , Berlin , Germany.
authors.forename: Alexander H
authors.initials: AH
authors.lastname: Thieme
authors.affiliation: Kantonsspital Graubünden , Chur , Switzerland.
authors.forename: Daniel R
authors.initials: DR
authors.lastname: Zwahlen
authors.affiliation: Department of Radiation Oncology, Charité Universitätsmedizin Berlin , Berlin , Germany.
authors.forename: Peter
authors.initials: P
authors.lastname: Wust
authors.affiliation: Bern University Hospital, University of Bern , Bern , Switzerland.
authors.forename: Daniel M
authors.initials: DM
authors.lastname: Aebersold
authors.affiliation: Department of Radiation Oncology, Charité Universitätsmedizin Berlin , Berlin , Germany.
authors.forename: Volker
authors.initials: V
authors.lastname: Budach
authors.affiliation: Department of Radiation Oncology, Charité Universitätsmedizin Berlin , Berlin , Germany.
authors.forename: Pirus
authors.initials: P
authors.lastname: Ghadjar
keywords: dose; prostate cancer; prostatectomy; radiation therapy; salvage