Postoperative Hypofractionated Radiation Therapy in Prostate Carcinoma: A Systematic Review

Anticancer Res. 2018 Mar;38(3):1221-1230. doi: 10.21873/anticanres.12343.


Background/aim: A systematic review on toxicity, local control (LC), overall survival (OS), and biochemical relapse-free survival (bRFS) after postoperative hypofractionated radiotherapy (HFRT) on prostate cancer (PCa) was performed.

Materials and methods: Based on the PRISMA methodology, studies reporting clinical results after adjuvant or salvage HFRT were included.

Results: A total of 1,208 patients from 17 eligible studies were included. Median follow-up was 30 months. No case of severe acute gastrointestinal (GI) toxicity was recorded. Grade ≥3 acute genitourinary (GU) toxicity ranged between 0% and 3%. Different rates of grade ≥2 late GI (range=0-8.7%) and GU (range=0-66%) toxicity were recorded. Encouraging results on LC, OS, and bRFS were reported.

Conclusion: Acute toxicity does not seem to be increased in patients receiving postoperative HFRT, but the results of late-GU toxicity are conflicting. Further prospective studies are needed before including postoperative HFRT in clinical practice.

Keywords: Hypofractionation; postoperative; prostate cancer; radiotherapy; review.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Disease-Free Survival
  • Humans
  • Male
  • Neoplasm Recurrence, Local
  • Postoperative Period
  • Prostate / pathology
  • Prostate / radiation effects*
  • Prostate / surgery
  • Prostatic Neoplasms / radiotherapy*
  • Prostatic Neoplasms / surgery
  • Radiation Dose Hypofractionation*
  • Radiotherapy, Adjuvant
  • Salvage Therapy