Urology Medical News about radical prostatectomy;PSA relapse;early salvage radiotherapy

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Early salvage radiotherapy for patients with PSA relapse after radical prostatectomy
Journal of Cancer Research & Clinical Oncology, 06/03/09

Tomita N et al. - In a study to assess the effectiveness of early salvage radiotherapy (RT) for pts with prostate-specific antigen (PSA) relapse after radical prostatectomy (RP) retrospectively, it was shown that although a total dose of 60 Gy was effective at low pre-RT PSA levels with short follow-up, an RT dose ≥60 Gy resulted in superior biochemical outcomes even in pts with a pre-RT PSA ≤0.50 ng/ml.

Methods

51 pts underwent salvage RT for biochemical relapse of prostate cancer (PCa) initially treated with RP.
All pts had persistent or rising PSA >0.20 ng/ml at some point after surgery, or 3 successive PSA elevations after a postoperative nadir if PSA was ≤0.20 ng/ml.
Most (96%) of pre-RT PSA were ≤0.50 ng/ml, and median value was 0.25 ng/ml.
Median RT dose was 60 Gy.
Multivariate Cox regression analysis was performed for PSA before RP and salvage RT, margin status, seminal vesicle involvement, extracapsular invasion, Gleason score, PSA doubling time (PSADT), and RT dose to identify significant predictors of biochemical outcome.

Results

Median follow-up was 36 mos.
3-yr biochemical no evidence of disease rate (bNED) was 55.1%.
On multivariate analysis, only the following factors were significantly associated with improved bNED: PSADT >3.0 mos, Gleason score ≤7, and RT dose ≥60 Gy.

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