[Adjuvant and salvage radiotherapy after radical prostatectomy]. / Tratamiento adyuvante y de rescate tras prostatectomía radical.

After radical prostatectomy is important to identify patients who have a high risk of microscopic residual disease without micrometastatic disease. Adjuvant RT, in retrospective studies, reduce the risk of recurrence and is more efficacious than salvage RT and can improve PSA relapse-free survival and should have an impact on long-term overall survival. The benefit of androgen suppression could be due to a synergistic interaction and may possibly eliminate occult systemic disease. Appropriate selection to identify subgroups of patients who may benefit from salvage RT, even for those patients at the highest risk; and whether some form of hormone ablation should accompany. To predict the biochemical failure and the risk of metastatic disease after salvage RT. We analyze the references to select an appropriate therapy. Improved outcomes will need to be tested in randomized trials.

Tratamiento adyuvante y de rescate tras prostatectomía radical / Adyuvant and salvage radiotherapy after radical prostatectomy

Tras la prostatectomía radical es importante identificar pacientes con alto riesgo de enfermedad microscópica residual en ausencia de enfermedad micrometastásica. La radioterapia adyuvante en estudios retrospectivos reduce las recurrencias locales y es más eficaz que la RT de rescate, aportando mejor supervivencia libre de recaída bioquímica y un potencial impacto en la supervivencia global. La supresión androgénica puede posiblemente eliminar la enfermedad oculta y aportar un efecto aditivo sobre el control local. Es posible identificar y seleccionar los pacientes que pueden beneficiarse de la Radioterapia de rescate, incluso los de alto riesgo. Se puede determinar la predicción de la progresión de PSA tras rescate con radioterapia y el riesgo de metástasis. Analizamos la bibliografía para un mejor enfoque terapéutico, basándonos en los datos actuales conocidos, a la espera de realización de nuevos ensayos clínicos (AU)

After radical prostatectomy is important to identify patients who have a high risk of microscopic residual disease without micrometastatic disease. Adyuvant RT, in retrospective studies, reduce the risk of recurrence and is more efficacious than salvage RT and can improve PSA relapse-free survival and should have an impact on long-term overall survival. The benefit of androgen suppresion could be due to a synergistic interaction and may possibly eliminate occult systemic disease. Appropiate selection to identify subgroups of patients who may benefit from salvage RT, even for those patients at the highest risk; and whether some form of hormone ablation should accompany. To predict the biochemical failure and the risk of metastasic disease after salvage RT. We analize the references to selection an appropiate therapy. Improves outcomes will need to be tested in randomized trials (AU)