PURPOSE: Salvage radiotherapy (SRT) is applied routinely in patients with biochemical relapse after radical prostatectomy (RP). However, only ∼30% of these patients achieve a durable response after 10 years. As a standard, 66 Gy are given, ideally with a PSA below 0.5 ng/ml. We tried to determine more precisely the optimal PSA for starting SRT. MATERIAL AND METHODS: In 301 prostate cancer patients without hormonal treatment, we analysed the impact on the biochemical response (bNED) to SRT of two pre-SRT PSA levels, namely below or above the median of 0.28 ng/ml. RESULTS: The median follow-up time for the entire group was 30 months. In 151 patients, SRT commenced at a PSA ≤ 0.28 ng/ml, in 150 at > 0.28 ng/ml. Eighty-two patients (27%) developed biochemical progression during follow up. The calculated two-year bNED was 74% for the entire group, 78% versus 61% for a PSA ≤ or > 0.28 ng/ml, respectively. In multivariate analysis, pT(3b), resection status, pre-SRT PSA dichotomized at median, PSA post-SRT undetectable, and PSA doubling time were statistically significant independent predictors of progression after SRT. CONCLUSIONS: Our findings suggest that a PSA of ≤ 0.28 ng/ml improves bNED compared with a PSA before SRT of > 0.28 ng/ml.
PURPOSE: Salvage radiotherapy (SRT) is applied routinely in patients with biochemical relapse after radical prostatectomy (RP). However, only ∼30% of these patients achieve a durable response after 10 years. As a standard, 66 Gy are given, ideally with a PSA below 0.5 ng/ml. We tried to determine more precisely the optimal PSA for starting SRT. MATERIAL AND METHODS: In 301 prostate cancerpatients without hormonal treatment, we analysed the impact on the biochemical response (bNED) to SRT of two pre-SRT PSA levels, namely below or above the median of 0.28 ng/ml. RESULTS: The median follow-up time for the entire group was 30 months. In 151 patients, SRT commenced at a PSA ≤ 0.28 ng/ml, in 150 at > 0.28 ng/ml. Eighty-two patients (27%) developed biochemical progression during follow up. The calculated two-year bNED was 74% for the entire group, 78% versus 61% for a PSA ≤ or > 0.28 ng/ml, respectively. In multivariate analysis, pT(3b), resection status, pre-SRT PSA dichotomized at median, PSA post-SRT undetectable, and PSA doubling time were statistically significant independent predictors of progression after SRT. CONCLUSIONS: Our findings suggest that a PSA of ≤ 0.28 ng/ml improves bNED compared with a PSA before SRT of > 0.28 ng/ml.
Authors: A Karl; A Buchner; C Tympner; T Kirchner; U Ganswindt; C Belka; R Ganzer; M Burger; F Eder; F Hofstädter; D Schilling; K Sievert; A Stenzl; M Scharpf; F Fend; F Vom Dorp; H Rübben; K Schmid; D Porres-Knoblauch; A Heidenreich; B Hangarter; R Knüchel-Clarke; M Rogenhofer; B Wullich; A Hartmann; E Comploj; A Pycha; E Hanspeter; D Pehrke; G Sauter; M Graefen; C Stief; A Haese Journal: World J Urol Date: 2015-02-15 Impact factor: 4.226
Authors: Gunnar Lohm; Dirk Bottke; Basil Jamil; Kurt Miller; Konrad Neumann; Detlef Bartkowiak; Wolfgang Hinkelbein; Thomas Wiegel Journal: World J Urol Date: 2012-03-30 Impact factor: 4.226
Authors: William C Jackson; Skyler B Johnson; Darren Li; Corey Foster; Benjamin Foster; Yeohan Song; Matthew Schipper; Mark Shilkrut; Howard M Sandler; Todd M Morgan; Ganesh S Palapattu; Daniel A Hamstra; Felix Y Feng Journal: Radiat Oncol Date: 2013-07-08 Impact factor: 3.481
Authors: D Hernandez; D Salas; D Giménez; P Buitrago; S Esquena; J Palou; P de la Torre; J Pernas; I Gich; G Gómez de Segura; J Craven-Bartle; G Sancho Journal: Radiat Oncol Date: 2015-12-24 Impact factor: 3.481