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Salvage of Locally Recurrent Prostate Cancer After Definitive Radiotherapy

Mendenhall, William M., MD*; Henderson, Randal H., MD, MBA; Hoppe, Bradford S., MD, MPH; Nichols, Romaine C., MD; Mendenhall, Nancy P., MD

American Journal of Clinical Oncology: August 2014 - Volume 37 - Issue 4 - p 411–416
doi: 10.1097/COC.0b013e31824be3b4
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Although a significant proportion of patients with localized prostate cancer are cured after definitive radiotherapy, solitary local recurrence is observed in a subset of patients and poses a management challenge. Curative-intent treatment options include prostatectomy, reirradiation, cryotherapy, and high-intensity–focused ultrasound. Outcomes data after any of these options are relatively limited. The 5-year biochemical progression-free survival rate is approximately 50% after salvage prostatectomy. However, the morbidity rate of the procedure is significantly higher compared with that observed in previously untreated patients. The likelihood of cure after low dose rate brachytherapy is similar to that observed after salvage prostatectomy, and the morbidity, although significant is less. Although cryotherapy and high-intensity–focused ultrasound may be less morbid than a prostatectomy, the probability of cure is probably lower.

*Department of Radiation Oncology, University of Florida College of Medicine, Gainesville

University of Florida Proton Therapy Institute, Jacksonville, FL

The authors declare no conflicts of interest.

Reprints: William M. Mendenhall, MD, 2000 SW Archer Rd., PO Box 100385, Gainesville, FL 32610-0385. E-mail: mendwm@shands.ufl.edu.

© 2014 by Lippincott Williams & Wilkins, Inc