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Timing of Early Salvage Therapy for Patients With Biochemical Relapse of Prostate Carcinoma

Between 25% and 33% of patients after radical prostatectomy experience a relapse of the disease. The risk of relapse increases in patients with risk factors up to 50%–80%. For a long time, adjuvant radiotherapy has been considered the standard of care. Four large prospective trials, that compared ad...

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Autores principales: Argalácsová, Soňa, Vočka, Michal, Čapoun, Otakar, Lambert, Lukáš
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10522833/
https://www.ncbi.nlm.nih.gov/pubmed/37771544
http://dx.doi.org/10.3389/or.2023.10676
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author Argalácsová, Soňa
Vočka, Michal
Čapoun, Otakar
Lambert, Lukáš
author_facet Argalácsová, Soňa
Vočka, Michal
Čapoun, Otakar
Lambert, Lukáš
author_sort Argalácsová, Soňa
collection PubMed
description Between 25% and 33% of patients after radical prostatectomy experience a relapse of the disease. The risk of relapse increases in patients with risk factors up to 50%–80%. For a long time, adjuvant radiotherapy has been considered the standard of care. Four large prospective trials, that compared adjuvant and salvage radiotherapy in patients with biochemical relapse, showed the superiority of the adjuvant approach in biochemical and local relapse-free survival, but no consistent benefit in long-term endpoints (i.e., metastasis-free survival, overall survival, or carcinoma-specific survival) at the expense of increased urinary and bowel toxicity. Three large international studies comparing adjuvant and salvage radiotherapy paved the way toward early salvage radiotherapy. However, the optimal threshold of the PSA level (range of 0.2–0.5 ng/mL) for initiating early salvage radiotherapy remains unresolved and still poses a challenge in everyday clinical practice when balancing the need for early radiotherapy and the associated toxicity. Imprecise stratification of biochemical relaps patients according to the risk of clinical relapse drives efforts to find additional molecular biomarkers that would improve the timing of the salvage therapy.
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spelling pubmed-105228332023-09-28 Timing of Early Salvage Therapy for Patients With Biochemical Relapse of Prostate Carcinoma Argalácsová, Soňa Vočka, Michal Čapoun, Otakar Lambert, Lukáš Oncol Rev Health Archive Between 25% and 33% of patients after radical prostatectomy experience a relapse of the disease. The risk of relapse increases in patients with risk factors up to 50%–80%. For a long time, adjuvant radiotherapy has been considered the standard of care. Four large prospective trials, that compared adjuvant and salvage radiotherapy in patients with biochemical relapse, showed the superiority of the adjuvant approach in biochemical and local relapse-free survival, but no consistent benefit in long-term endpoints (i.e., metastasis-free survival, overall survival, or carcinoma-specific survival) at the expense of increased urinary and bowel toxicity. Three large international studies comparing adjuvant and salvage radiotherapy paved the way toward early salvage radiotherapy. However, the optimal threshold of the PSA level (range of 0.2–0.5 ng/mL) for initiating early salvage radiotherapy remains unresolved and still poses a challenge in everyday clinical practice when balancing the need for early radiotherapy and the associated toxicity. Imprecise stratification of biochemical relaps patients according to the risk of clinical relapse drives efforts to find additional molecular biomarkers that would improve the timing of the salvage therapy. Frontiers Media S.A. 2023-09-13 /pmc/articles/PMC10522833/ /pubmed/37771544 http://dx.doi.org/10.3389/or.2023.10676 Text en Copyright © 2023 Argalácsová, Vočka, Čapoun and Lambert. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Health Archive
Argalácsová, Soňa
Vočka, Michal
Čapoun, Otakar
Lambert, Lukáš
Timing of Early Salvage Therapy for Patients With Biochemical Relapse of Prostate Carcinoma
title Timing of Early Salvage Therapy for Patients With Biochemical Relapse of Prostate Carcinoma
title_full Timing of Early Salvage Therapy for Patients With Biochemical Relapse of Prostate Carcinoma
title_fullStr Timing of Early Salvage Therapy for Patients With Biochemical Relapse of Prostate Carcinoma
title_full_unstemmed Timing of Early Salvage Therapy for Patients With Biochemical Relapse of Prostate Carcinoma
title_short Timing of Early Salvage Therapy for Patients With Biochemical Relapse of Prostate Carcinoma
title_sort timing of early salvage therapy for patients with biochemical relapse of prostate carcinoma
topic Health Archive
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10522833/
https://www.ncbi.nlm.nih.gov/pubmed/37771544
http://dx.doi.org/10.3389/or.2023.10676
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