Published online Jan 24, 2020. doi: 10.5306/wjco.v11.i1.1
Peer-review started: July 17, 2019
First decision: October 14, 2019
Revised: November 13, 2019
Accepted: November 18, 2019
Article in press: November 18, 2019
Published online: January 24, 2020
Core tip: Salvage radiotherapy (SRT) is an effective treatment for biochemically-recurrent prostate cancer after prostatectomy. Proper patient selection is crucial. While tumour-related factors are important, the indication for SRT should also be based on clinical factors and dosimetric variables. Patients with non-aggressive tumours who have a life expectancy of less than 10 years are unlikely to benefit from radiotherapy and should thus be considered "unfit" for SRT. The development of advanced imaging techniques such Ga-PSMA positron emission tomography/computed tomography, which are capable of localizing the recurrent lesion when prostate-specific antigen ≤ 0.5 ng/mL, has forced clinicians to reconsider whether patients should undergo radiotherapy without locate first the recurrence.