Evaluation of radiation effect, tumor differentiation, and prostate specific antigen staining in sequential prostate
biopsies after external beam radiotherapy for patients with prostate carcinoma.

Crook JM, Bahadur YA, Robertson SJ, Perry GA, Esche BA.
Cancer 1997, 79: 81-89.

This retrospective observational study identifies the features present within prostate biopsies following
radiotherapy for prostate cancer that signify local failure and may justify aggressive salvage therapy. The
radiotherapy effect (cytoplasmic and nuclear cellular changes) on the prostate can be scored and the presence of
residual tumour cells showing minimal RT effect in 24-36 month biopsies predicts subsequent local failure. The
authors recommend performing biopsies to identify potential failures early.