Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Oncol. Jan 24, 2020; 11(1): 1-10
Published online Jan 24, 2020. doi: 10.5306/wjco.v11.i1.1
Are all prostate cancer patients "fit" for salvage radiotherapy?
Carmen González-San Segundo, Alfonso Gómez-Iturriaga, Felipe Couñago
Carmen González-San Segundo, Department of Radiation Oncology, HGU Gregorio Marañon, Complutense University, Madrid 28007, Spain
Alfonso Gómez-Iturriaga, Biocruces Health Research Institute, Cruces University Hospital, Barakaldo 48903, Spain
Felipe Couñago, Department of Radiation Oncology, Hospital Universitario Quirónsalud Madrid, Madrid 28003, Spain
Author contributions: All authors contributed to this manuscript.
Conflict-of-interest statement: Authors declare no conflict of interests for this article.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Carmen González-San Segundo, MD, PhD, Professor, Department of Radiation Oncology, HGU Gregorio Marañon, Complutense University, C/Doctor Esquerdo 46, Madrid 28007, Spain. cglezss@gmail.com
Received: July 5, 2019
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

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.