After surgery, prostate cancer recurs in 40% of patients, indicated by rising prostate-specific antigen (PSA) levels. This is often treated with salvage radiotherapy (SRT), which targets the area where the prostate was located. Unfortunately, SRT is effective in only 55% of patients and can cause adverse effects. This thesis of Floor Staal explores how SRT can be delivered more precisely and effectively.
A key component of this research is the PERYTON study, which compares a new, shorter radiation method (20 treatments with a higher dose) to the standard method (35 treatments with a lower dose). This approach could be more efficient and result in fewer adverse effects. Sometimes, it is unclear whether the cancer recurred to the original location or has spread. A special scan (PSMA-PET/CT) helps to better identify the location of the prostate cancer recurrence.
This thesis also examines how SRT is applied in the Netherlands. Not all patients eligible for SRT actually receive the treatment, and doctors apply it in varied ways. To improve the precision of radiation, a new guideline was developed using PSMA PET scans. This helps doctors better target where radiation is needed. The research also shows that the new, shorter radiation method is safe and practically feasible.
This thesis contributes to a more effective and patient-friendly treatment for recurrent prostate cancer after surgery.
