Revisiting Post-Prostatectomy Salvage Radiation in the Age of Precision Oncology

This activity covers updates and evolving data in treating biochemically recurrent prostate cancer post-prostatectomy. One speaker covers fractionation: can we safely hypofractionate in the post-operative setting, or is the data more supportive of conventional fractionation? Several single institution studies have examined SBRT in this setting, is SBRT to the reconstructed post-RP pelvis ready for prime time? A second speaker addresses field and timing: in the era of SPPORT and POP-RT, do we recommend pelvic RT for everyone? And in the era of PSMA PET, have we learned anything about local patterns of failure that enable us to refine our prostate fossa target? Also, how "early" should early salvage radiation be - should we follow criteria from trials like RADICALS, or should we wait for a higher PSA to customize the field to a PSMA PET target? A third speaker from medical oncology addresses the use of systemic therapy with salvage radiation: with Decipher and Artera AI, what tools should we be using to inform the ADT decision for these patients? And is there adequate data to add androgen receptor pathway inhibitors for high-risk patients?

Topics:

  1. Is Hypofractionation the New Standard of Care for Salvage Post-prostatectomy Radiation? 
    Mark A. Buyyounouski, MD, MS, FASTRO
  2. Rethinking Target and Timing for Salvage Post-prostatectomy Radiation
    Stanley Liauw, MD, FASTRO
  3. Choosing Systemic Therapy in the Salvage Setting
    Michael Schweizer, MD
  4. Q and A
    Emily Steinberger Weg, MD – Moderator
    Full Panel

This activity is available from February 17, 2026, through 11:59 p.m. Eastern time on February 16, 2028. 

The content was originally presented and recorded at the 2025 ASTRO Annual Meeting.

Target Audience

The activity is designed to meet the interests of medical oncologists, radiation oncologists, surgeons, diagnostic radiologists and residents.

Learning Objectives

Upon completion of this activity, participants should be able to:

  • Determine the most appropriate fractionation regimen to be used in the post-prostatectomy salvage radiation setting.
  • Assess whether the pelvic nodes need to always be included in the post-prostatectomy salvage setting, and how to utilize PSMA PET data to inform the prostate bed target.
  • Consider when to use hormone therapy for post-prostatectomy salvage radiation patients and which agents are most appropriate.
Course summary
Available credit: 
  • 1.00 AMA PRA Category 1 Credit™

    The American Society for Radiation Oncology (ASTRO) is accredited by the Accreditation Council for Continuing Medical Education for physicians. ASTRO designates this Enduring material for a maximum of 1.00 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

  • 1.00 Certificate of Attendance
    This activity was designated for 1.00 AMA PRA Category 1 Credit™.
Course opens: 
02/17/2026
Course expires: 
02/16/2028
Cost:
$149.00
Rating: 
0

Moderator: 

  • Emily Steinberger Weg, MD, is employed by Weill Cornell Medical College. Dr. Weg has no relevant financial relationship with ineligible companies to disclose.   

Speakers: 

  • Mark K. Buyyounouski, MD, MS, FASTRO, is employed by Stanford University School of Medicine. Dr. Buyyounouski has no relevant financial relationship with ineligible companies to disclose.   
  • Stanley Liauw, MD, FASTRO, is employed by University of Chicago. Dr. Liauw has no relevant financial relationship with ineligible companies to disclose.   
  • Michael Schweizer, MD, is employed by University of Washington. Dr. Schweizer has no relevant financial relationship with ineligible companies to disclose.   

Planners:

  • Malcolm Mattes, MD is employed at Rutgers Cancer Institute. Dr. Mattes received research/grant funding from Gilead Sciences (relationship ended 8/30/2025). Dr. Mattes has no relevant financial relationship with ineligible companies. 
  • Parul Barry, MD, is employed by the University of Pittsburgh Medical Center. Dr. Barry has no relevant financial relationship with ineligible companies. 
  • Michael Haddock, MD, is employed by Mayo Clinic and has no relevant financial relationship with ineligible companies to disclose.
  • Manisha Palta, MD, is employed by Duke Cancer Center and Duke University Hospital. Dr. Palta receives grant/research funding from Merck and Varian Medical Systems. 
  • Salma Jabbour, MD, is employed by Rutgers Cancer Institute. Dr. Jabbour receives grant/research funding from Merck & Co., Inc. and Beigene. Dr. Jabbour receives compensation/payment as a consultant with Radialogica and IMX Medical. 

All relevant financial relationships have been mitigated.

The American Society for Radiation Oncology (ASTRO) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Available Credit

  • 1.00 AMA PRA Category 1 Credit™

    The American Society for Radiation Oncology (ASTRO) is accredited by the Accreditation Council for Continuing Medical Education for physicians. ASTRO designates this Enduring material for a maximum of 1.00 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

  • 1.00 Certificate of Attendance
    This activity was designated for 1.00 AMA PRA Category 1 Credit™.

Price

Cost:
$149.00
Please login or register to take this course.

Course Fees:
ASTRO members must log in to the ASTRO website to view and receive the member rate.

  • Nonmember: $149
  • Member: $99
  • Member-in-Training: $49
  • Student/Graduate Student/PGY-1 Member: $49
  • Postdoctoral Fellow Member: $49

If you are an ASTRO member from a low or lower-middle income country, as identified by the World Bank, you can receive a 50% discount off your corresponding registration for this activity. Please email [email protected] to inquire about the discount.

Policies:
No refunds, extensions, or substitutions will be made for those participants who, for any reason, have not completed the activity by the expiration date. 

Participants using ASTRO Academy activities to satisfy the requirement of a Continuing Certification (MOC) program should verify the credit number and type and availability dates of any activity before making a purchase. No refunds, extensions, or substitutions will be made for participants who have purchased activities that do not align with their MOC requirement.

The activity and its materials will only be available on the ASTRO website until February 16, 2028, regardless of purchase date. At the expiration of the activity, participants will no longer have access to the activity or its materials. ASTRO reserves the right to remove an activity before its expiration date. 

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