Use of Radiotherapy After Prostate Cancer Surgery Declining, Despite Evidence of Benefit

“Despite strong evidence and guidelines supporting its use, post-surgical radiation therapy for prostate cancer patients at risk of recurrence is declining in the United States. The study, published online in the journal European Urology, finds fewer than 10 percent of patients at risk of recurrence received postoperative radiotherapy within six months of surgery in the U.S.

“Although radical prostatectomy (RP) is a common curative treatment for localized prostate cancer, about 30% of patients will develop biochemical recurrence after surgery, meaning their prostate-specific antigen (PSA) level will again rise. For some patients with more aggressive cancers, as many as 60% to 70% can experience biochemical recurrence (also called biochemical failure).

“Three large randomized prospective clinical trials, two done in Europe and one in the United States, have demonstrated that postoperative radiotherapy (RT) in patients with adverse pathological features reduces risk of PSA recurrence, may prevent the need for androgen deprivation therapy (ADT), and may reduce metastasis and improve survival.”