Post-Operative Radiation Treatment for Prostate Cancer

During the decades after radical prostatectomy, in the case of high risk features on pathological specimens, adjuvant postoperative radiation treatment (RT) was indicated for survival benefit based on three major prospective international studies. These trials emphasized the use for adjuvant local radiotherapy compared to the observation alone but also that almost 50% of patients in the observation remained without evidence of recurrence. With the introduction of PSA testing as a surrogate marker to differentiate adjuvant to salvage irradiation options, trends in practice began to shift toward early salvage treatment to avoid a majority of unnecessary adjuvant treatment. Recently, three more prospective trials and a meta-analysis gathering the results of these studies were published based on the comparison of adjuvant versus salvage RT. In this setting, the timing to initiate radiotherapy (adjuvant or salvage), the benefit of combining hormones to RT, the volume of treatment, the need for treatment intensification (dose, combination of systemic treatment added to RT) were some of the issues that arose in the current practice.

In this Research Topic, we would like to present recent data on the subject of postoperative prostate cancer radiation treatment for high-risk prostate cancer. Articles will address a broad variety of subjects, ranging from imaging evaluation, technical aspects of local therapies, clinical outcomes in various situations, current practice research and ongoing clinical trials. The aim of this Research Topic is to provide an updated perspective on the timing and benefit of local therapies for high-risk postoperative prostate cancer.

This Research Topic intends to foster discussions on current controversies in the use of postoperative radiotherapy as well as novel perspectives for treatment optimization.

Important Note: All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to guide an out-of-scope manuscript to a more suitable section or journal at any stage of peer review.

Please note: manuscripts consisting solely of bioinformatics or computational analysis of public genomic or transcriptomic databases which are not accompanied by validation (independent cohort or biological validation in vitro or in vivo) are out of scope for this section and will not be accepted as part of this Research Topic.