Adjuvant and Salvage Radiotherapy after Prostatectomy Guideline statements Purpose: The purpose of this guideline is to provide direction to clinicians and patients regarding the use of radiotherapy after radical prostatectomy in the adjuvant or salvage setting. The strategies and approaches recommended in the guideline were derived from evidence-based and consensus-based processes. This document constitutes aclinical strategy; therefore, the most effective treatment approach for a particular patient is best determined by the patient, his family, and amulti-disciplinary team of providers using the shared decision-making model. This guideline amendment incorporates newly-published literature into the original ASTRO/AUA Adjuvant and Salvage Radiotherapy after Prostatectomy Guideline and to provide an updated clinical framework for clinicians. 目的:本指南的目的是为临床医生和患者提供对于前列腺切除术后的辅助和挽救放射治疗的指导。指南中治疗方法来自基于临床数字证据和基于专家共识。因此，针对特定患者的最有效治疗方法最好由患者及家属，以及使用共享决策模型的提供者多学科团队决定。该指南纳入前列腺切除术后的辅助和挽救放射治疗最新出版的文献修正案，为临床医生提供了最新的临床框架。 Guideline Statement 1 Patients who are being considered for management of localized prostate cancer with radical prostatectomy should be informed of the potential for adverse pathologic findings that portend a higher risk of cancer recurrence and that these findings may suggest a potential benefit of additional therapy after surgery. (Clinical Principle) 指南声明1 对根治性前列腺切除术治疗局限性前列腺癌的患者，应了解导致癌症复发高风险的不良病理学发现，并且这些发现可能提示手术后额外治疗有潜在的益处。 （临床原则） Guideline Statement 2 Patients with adverse pathologic findings including seminal vesicle invasion, positive surgical margins, and extraprostatic extension should be informed that adjuvant radiotherapy, compared to radical prostatectomy only, reduces the risk of biochemical recurrence, local recurrence, and clinical progression of cancer. They should also be informed that the impact of adjuvant radiotherapy on subsequent metastases and overall survival is less clear; one of three randomized controlled trials that addressed these outcomes indicated a benefit but the other two trials did not demonstrate a benefit. However, these two trials were not designed to identify a significant reduction in metastasis or death with adjuvant radiotherapy. (Clinical Principle) 指南声明2 病理结果差的患者，包括精囊浸润，手术切缘阳性和前列腺外扩散，应告知，与根治性前列腺切除术相比，辅助放射治疗可降低生化复发，局部复发和癌症临床进展的风险。还应该被告知，辅助放射治疗对随后的转移和总体生存的影响不太明显; 三项针对这些结果的随机对照试验中的一项表明有益，但另外两项试验没有证明有益。然而，这两项试验的目的并不是通过辅助放疗确定转移或降低死亡率。 （临床原理） Guideline Statement 3 Physicians should offer adjuvant radiotherapy to patients with adverse pathologic findings at prostatectomy including seminal vesicle invasion, positive surgical margins, or extraprostatic extension because of demonstrated reductions in biochemical recurrence, local recurrence,and clinical progression. (Standard; Evidence Strength: Grade A) 指南声明3 医生应为前列腺切除术患者（包括精囊浸润，手术切缘阳性）提供辅助放射治疗以降低生化复发，局部复发和临床进展。 （标准;证据强度：A级） Guideline Statement 4 Patients should be informed that the development of a PSA recurrence after surgery is associated with a higher risk of development of metastatic prostate cancer or death from the disease. Congruent with this clinical principle, physicians should regularly monitor PSA after radical prostatectomy to enable early administration of salvage therapies if appropriate. (Clinical Principle) 指南声明4 应告知患者，手术后PSA复发的发展与转移性前列腺癌的发展风险或疾病死亡有关。与此临床原则一致，医生应在根治性前列腺切除术后定期监测PSA，以便在适当的情况下尽早进行挽救性治疗。 （临床原理） Guideline Statement 5 Clinicians should define biochemical recurrence as a detectable or rising PSA value after surgery that is ≥ 0.2 ng/ml with a second confirmatory level ≥ 0.2 ng/ml.(Recommendation; Evidence Strength: Grade C) 指南声明5 临床医生应将生化复发定义为手术后可检测到的组织PSA值≥0.2ng / ml，第二次验证水平≥0.2ng / ml。（推荐;证据强度：C级） Guideline Statement 6 A restaging evaluation in the patient with a PSA recurrence may be considered. (Option; Evidence Strength: Grade C) 指南声明6 对复发患者PSA再分期评估。（选项;证据强度：C级） Guideline Statement 7 Physicians should offer salvage radiotherapy to patients with PSA or local recurrence after radical prostatectomy in whom there is no evidence of distant metastatic disease.(Recommendation; Evidence Strength: Grade C) 指南声明7 医生应为根治性前列腺切除术后PSA升高或局部复发的患者提供挽救性放疗，无远处转移的证据。（推荐;证据强度：C级） Guideline Statement 8 Patients should be informed that the effectiveness of radiotherapy for PSA recurrence is greatest when given at lower levels of PSA. (Clinical Principle) 指南声明8 应告知患者，当PSA水平较低时，放疗对PSA复发的有效性最大。（临床原理） Guideline Statement 9 Clinicians should offer hormone therapy to patients treated with salvage radiotherapy (postoperative PSA ≥0.20 ng/mL) Ongoing research may someday allow personalized selection of hormone or other therapies within patient subsets. (Standard; Evidence Strength: Grade A) 指南声明9 临床医生应为接受挽救性放疗的患者提供激素治疗（术后PSA≥0.20ng/ mL）。正在进行的研究可能有一天在患者亚组内个性化选择激素或其他疗法。（标准;证据强度：A级） Guideline Statement 10 Patients should be informed of the possible short-term and long-term urinary, bowel, and sexual side effects of radiotherapy as well as of the potential benefits of controlling disease recurrence. (Clinical Principle) 指南声明10 应告知患者短期和长期放疗，肠道和性功能副作用以及控制疾病复发的潜在益处。（临床原理） PDF指南全文获取 方式一：
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