This really depends upon your use case.
Using the PostgreSQL storage has the advantage of storing all the information at the same place, and of benefiting from all the advantages of an enterprise database (security, backup, clustering, scalability, redundancy...).
Using a filesystem storage has the advantage of the lightness, and of putting less load on the database server.
Yes, of course, you just have to set the configuration option "EnableStorage" to "false" in the "PostgreSQL" section of your configuration file. In this case, the DICOM files will be stored in the folder referred to by the "OrthancStorage" configuration option, as in the core version of Orthanc.
This is explained on the following Web page:
What is safe?
If your "OrthancStorage" folder is properly backup, the two options should be safe.
HTH,
Sébastien-