The authors of the article want to warn about the desirability of a better selection of patients who have a biochemical recurrence and who can benefit from salvage radiotherapy and, especially, to raise the need for the use of advanced imaging techniques. Novel diagnostic techniques such as multiparametric MRI or PET/CT, allow us to better identify patients who may benefit from local treatments and may also help us to tailor treatment. We must not continue treating all patients blindly.
The proposed algorithm in our manuscript (Figure 1), is simple and feasible; is a tool to optimize patient selection and to better treat them, supported by stratification of patients in risk groups (Table 1). We encourage radiation oncologist colleagues to incorporate it into their clinical practice and exchange experiences and results.
Fig. 1 Algorithm of biochemical recurrence
*Chemotherapy addition according to multidisciplinary board decision.
** SRT if patients assume the risks.
Table 1. Treatment recommendation based on three risk groups
Written by: Carmen González-San Segundo, MD, Department of Radiation Oncology, HGU Gregorio Marañon, Complutense University, Madrid, Spain; Alfonso Gómez-Iturriaga, MD, Biocruces Health Research Institute, Cruces University Hospital, Barakaldo, Spain; Felipe Couñago, MD, Department of Radiation Oncology, Hospital Universitario Quirónsalud Madrid, Madrid, Spain.
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