Detlef Bartkowiak1, Dirk Bottke1, Reinhard Thamm1, Alessandra Siegmann2, Wolfgang Hinkelbein2, Thomas Wiegel3. 1. University Hospital Ulm, Department of Radiation Oncology, Ulm, Germany. 2. Charité University Hospital, Department of Radiation Oncology, Berlin, Germany. 3. University Hospital Ulm, Department of Radiation Oncology, Ulm, Germany. Electronic address: thomas.wiegel@uniklinik-ulm.de.
Abstract
BACKGROUND AND PURPOSE: In a retrospective analysis, we examined factors influencing the outcome of prostate cancer (PCa) patients receiving salvage radiotherapy (SRT) for PSA recurrence after radical prostatectomy (RP). MATERIAL AND METHODS: 306 patients received 3D-conformal SRT at a median pre-SRT PSA of 0.298 ng/ml. Post-SRT progression was defined as PSA ⩾0.2 ng/ml above nadir and rising further, or hormone treatment, or clinical recurrence. Data were analyzed with the Kaplan-Meier method and multivariable Cox regression. RESULTS: Application of SRT at a PSA <0.2 ng/ml correlated significantly with achieving a post-SRT PSA nadir <0.1 ng/ml and with improved freedom from progression (median follow-up 7.2 years). The post-SRT nadir <0.1 ng/ml correlated significantly with less recurrences and with better overall survival. In multivariable Cox analysis restricted to pre-SRT parameters, a pre-SRT PSA ⩾0.2 ng/ml had the strongest impact (hazard ratio 2.4) on progression. If the post-SRT PSA nadir was included in the model, then failing the nadir was the most important risk factor (hazard ratio 8.1). CONCLUSIONS: Early SRT at a PSA <0.2 ng/ml is a favorable treatment option for post-RP biochemical recurrence. It correlated with a post-SRT PSA-nadir <0.1 ng/ml which was associated with improved freedom from progression and overall survival.
BACKGROUND AND PURPOSE: In a retrospective analysis, we examined factors influencing the outcome of prostate cancer (PCa) patients receiving salvage radiotherapy (SRT) for PSA recurrence after radical prostatectomy (RP). MATERIAL AND METHODS: 306 patients received 3D-conformal SRT at a median pre-SRT PSA of 0.298 ng/ml. Post-SRT progression was defined as PSA ⩾0.2 ng/ml above nadir and rising further, or hormone treatment, or clinical recurrence. Data were analyzed with the Kaplan-Meier method and multivariable Cox regression. RESULTS: Application of SRT at a PSA <0.2 ng/ml correlated significantly with achieving a post-SRT PSA nadir <0.1 ng/ml and with improved freedom from progression (median follow-up 7.2 years). The post-SRT nadir <0.1 ng/ml correlated significantly with less recurrences and with better overall survival. In multivariable Cox analysis restricted to pre-SRT parameters, a pre-SRT PSA ⩾0.2 ng/ml had the strongest impact (hazard ratio 2.4) on progression. If the post-SRT PSA nadir was included in the model, then failing the nadir was the most important risk factor (hazard ratio 8.1). CONCLUSIONS: Early SRT at a PSA <0.2 ng/ml is a favorable treatment option for post-RP biochemical recurrence. It correlated with a post-SRT PSA-nadir <0.1 ng/ml which was associated with improved freedom from progression and overall survival.
Authors: Julian Müller; Daniela A Ferraro; Urs J Muehlematter; Helena I Garcia Schüler; Sarah Kedzia; Daniel Eberli; Matthias Guckenberger; Stephanie G C Kroeze; Tullio Sulser; Daniel M Schmid; Aurelius Omlin; Alexander Müller; Thomas Zilli; Hubert John; Helmut Kranzbuehler; Philipp A Kaufmann; Gustav K von Schulthess; Irene A Burger Journal: Eur J Nucl Med Mol Imaging Date: 2018-11-28 Impact factor: 9.236
Authors: Marco M E Vogel; Sabrina Dewes; Eva K Sage; Michal Devecka; Jürgen E Gschwend; Matthias Eiber; Stephanie E Combs; Kilian Schiller Journal: Radiat Oncol Date: 2021-05-01 Impact factor: 4.309