Biochemical relapse after radical prostatectomy occurs in approximately 15ââ?¬â??40% of patients within 5 years. Postoperative radiotherapy\r\nis the only curative treatment for these patients. After radical prostatectomy, two different strategies can be offered,\r\nadjuvant or salvage radiotherapy. Adjuvant radiotherapy is defined as treatment given directly after surgery in the presence of\r\nrisk factors (R1 resection, pT3) before biochemical relapse occurs. It consists of 60ââ?¬â??64Gy and was shown to increase biochemical\r\nrelapse-free survival in three randomized controlled trials and to increase overall survival after a median followup of 12.7 years in\r\none of these trials. Salvage radiotherapy, on the other hand, is given upon biochemical relapse and is the preferred option, by many\r\ncenters as it does not include patients who might be cured by surgery alone. As described in only retrospective studies the dose\r\nfor salvage radiotherapy ranges from 64 to 72Gy and is usually dependent on the absence or presence of macroscopic recurrence.\r\nRandomized trials are currently investigating the role of adjuvant and salvage radiotherapy. Patients with biochemical relapse after\r\nprostatectomy should at the earliest sign of relapse be referred to salvage radiotherapy and should preferably be treated within a\r\nclinical trial.
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