Salvage treatments following prostate radiation therapy: Role of the urologist

摘要

The management of recurrent prostate cancer after radiotherapy or brachytherapy is non-standardized and rapidly evolving. Local recurrence is observed on average in 30% of cases several years following irradiation. A key challenge is to determine the site of recurrence and imaging (MRI and PET choline) coupled to prostate biopsies are important to confirm the local character. Salvage therapy performed by the urologist can then control the situation. Radical prostatectomy subject to strict technical conditions is one of the most efficient local treatments, however it comes at the cost of significant urinary morbidity; minimally invasive therapies (focused ultrasound and cryotherapy) have also their place in specific indications. Each clinical situation should be discussed in pluridisciplinary meetings integrating the oncologic and functional status at recurrence, the risk/benefit ratio of each treatment, the patient's wishes and probability of survival. (C) 2014 Societe francaise de radiotherapie oncologique (SFRO). Published by Elsevier Masson SAS. All rights reserved.