迄今为止，考虑到接受放射治疗并随后出现生化复发的局限性 PCa 的男性人数，放射性复发性前列腺癌 (PCa) 被列为第四大常见泌尿系统恶性肿瘤。本系统综述旨在总结关于初次外照射放射治疗 (EBRT) 后局部 PCa 复发患者的局部挽救策略结果的现有证据。我们对 MEDLINE、Scopus 和 Web of Science 核心合集数据库进行了全面的书目检索2023 年 10 月，旨在确定过去 20 年发表的研究，评估 EBRT 后局部放射复发 PCa 患者的局部挽救手术的结果。当两项或多项研究报告相同结果时，使用 ProMeta 3 软件进行荟萃分析。效应大小 (ES) 使用报告的 95% 置信区间 (CI) 来估计。总体而言，本次评价纳入了 28 项研究（6 项前瞻性研究和 22 项回顾性研究），包括 1544 名患者。两年无复发生存率 (RFS) 为 84.0% (95% CI: 67.0-93.0%)、69.0% (95% CI: 42.0-87.0%)、58.0% (95% CI: 43.0-71.0%)、对于接受近距离放射治疗 (BT)、EBRT、冷冻疗法和高强度聚焦超声 (HIFU) 的患者，这一比例分别为 45% (95% CI: 38.0-52.0%)。挽救性前列腺切除术后，中位随访时间为 18 至 35 个月，RFS 范围为 75% 至 78.5%。冷冻疗法、BT、HIFU、EBRT 和挽救性根治性前列腺切除术后严重胃肠道毒性的估计分别为 2%、3%、3%、4% 和 11%。通过 BT 或 EBRT 进行的照射代表了在疗效和安全性之间提供最佳平衡的方式。不幸的是，由于证据水平较低，无法就这些技术的选择提出强有力的建议。© 2024。作者，获得施普林格自然有限公司的独家许可。

To date, radio-recurrent prostate cancer (PCa) ranks as the fourth most common urological malignancy when considering the number of men with localized PCa who undergo radiation treatment and subsequently experience a biochemical recurrence. This systematic review aimed to summarize available evidence about the outcomes of local salvage strategies in patients with local PCa recurrence following primary external-beam radiation therapy (EBRT).We conducted a comprehensive bibliographic search on MEDLINE, Scopus, and Web of Science Core Collection databases in October 2023 to identify studies published in the last 20 years evaluating outcomes of local salvage procedures in patients with locally radio-recurrent PCa following EBRT. The meta-analysis was performed using ProMeta 3 software when two or more studies reported the same outcome. The effect size (ES) was estimated using rates reported with its 95% confidence interval (CI).Overall, 28 studies (6 prospective and 22 retrospective) including 1544 patients were included in the review. Two-year recurrence-free survival (RFS) was 84.0% (95% CI: 67.0-93.0%), 69.0% (95% CI: 42.0-87.0%), 58.0% (95% CI: 43.0-71.0%), and 45% (95% CI: 38.0-52.0%), for patients undergoing brachytherapy (BT), EBRT, Cryotherapy and High-Intensity Focused Ultrasound (HIFU), respectively. After salvage prostatectomy, RFS ranged from 75% to 78.5% at a median follow-up ranging from 18 to 35 months. Estimates for severe gastrointestinal toxicity were 2%, 3%, 3%, 4%, and 11% following cryotherapy, BT, HIFU, EBRT, and salvage radical prostatectomy, respectively.In patients who underwent EBRT as primary treatment, prostate salvage re-irradiation through BT or EBRT represents the modality providing the best balance between efficacy and safety. Unfortunately, due to the low level of evidence, strong recommendations regarding the choice of any of these techniques cannot be made.© 2024. The Author(s), under exclusive licence to Springer Nature Limited.