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Salvage radiotherapy for men with isolated rising PSA or locally palpable recurrence after radical prostatectomy: do outcomes differ?
Urology. 2004 Oct; 64(4):760-4.U

Abstract

OBJECTIVES

To compare, in a retrospective analysis, the outcome of salvage external beam radiotherapy (EBRT) for isolated prostate-specific antigen (PSA) elevation or palpable local recurrence after radical prostatectomy (RP).

METHODS

We evaluated 102 men who underwent EBRT from 1993 to 1999, 60 for a rising PSA level alone and 42 for palpable local disease after RP. Biochemical disease-free survival and overall survival were calculated. Prognostic factors were evaluated to determine associations with biochemical disease-free survival.

RESULTS

The 5-year rate of biochemical disease-free survival, local control, freedom from distant metastasis, and overall survival for all 102 patients was 38%, 94%, 87%, and 88%, respectively. All palpable disease resolved completely after salvage EBRT. The greatest 5-year rate of biochemical control (69%) was obtained in patients with a pre-EBRT PSA level of 0.5 ng/mL or less. The 5-year overall survival rate was significantly better for those who underwent salvage EBRT for a rising PSA level than for those with palpable recurrence (96% versus 78%, P = 0.02). A low pre-EBRT PSA level and a less than 2-year interval from RP to EBRT were independent predictors of biochemical failure. Five patients (5%) experienced chronic grade 3 or 4 RT-related toxicity.

CONCLUSIONS

Salvage EBRT provides excellent local control of recurrent disease after RP. Salvage EBRT before the development of palpable local disease may confer a survival benefit and decrease the risk of metastasis, and durable biochemical control was achieved best in those whose pre-EBRT PSA level was 0.5 ng/mL or less. Early referral and careful patient selection is vital for salvage EBRT to be of optimal benefit.

Authors+Show Affiliations

Department of Radiation Oncology, Mayo Clinic Scottsdale, Scottsdale, Arizona 85259, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Evaluation Study
Journal Article

Language

eng

PubMed ID

15491716

Citation

MacDonald, O Kenneth, et al. "Salvage Radiotherapy for Men With Isolated Rising PSA or Locally Palpable Recurrence After Radical Prostatectomy: Do Outcomes Differ?" Urology, vol. 64, no. 4, 2004, pp. 760-4.
MacDonald OK, Schild SE, Vora S, et al. Salvage radiotherapy for men with isolated rising PSA or locally palpable recurrence after radical prostatectomy: do outcomes differ? Urology. 2004;64(4):760-4.
MacDonald, O. K., Schild, S. E., Vora, S., Andrews, P. E., Ferrigni, R. G., Novicki, D. E., Swanson, S. K., & Wong, W. W. (2004). Salvage radiotherapy for men with isolated rising PSA or locally palpable recurrence after radical prostatectomy: do outcomes differ? Urology, 64(4), 760-4.
MacDonald OK, et al. Salvage Radiotherapy for Men With Isolated Rising PSA or Locally Palpable Recurrence After Radical Prostatectomy: Do Outcomes Differ. Urology. 2004;64(4):760-4. PubMed PMID: 15491716.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Salvage radiotherapy for men with isolated rising PSA or locally palpable recurrence after radical prostatectomy: do outcomes differ? AU - MacDonald,O Kenneth, AU - Schild,Steven E, AU - Vora,Sujaya, AU - Andrews,Paul E, AU - Ferrigni,Robert G, AU - Novicki,Donald E, AU - Swanson,Scott K, AU - Wong,William W, PY - 2004/03/01/received PY - 2004/10/20/pubmed PY - 2005/8/13/medline PY - 2004/10/20/entrez SP - 760 EP - 4 JF - Urology JO - Urology VL - 64 IS - 4 N2 - OBJECTIVES: To compare, in a retrospective analysis, the outcome of salvage external beam radiotherapy (EBRT) for isolated prostate-specific antigen (PSA) elevation or palpable local recurrence after radical prostatectomy (RP). METHODS: We evaluated 102 men who underwent EBRT from 1993 to 1999, 60 for a rising PSA level alone and 42 for palpable local disease after RP. Biochemical disease-free survival and overall survival were calculated. Prognostic factors were evaluated to determine associations with biochemical disease-free survival. RESULTS: The 5-year rate of biochemical disease-free survival, local control, freedom from distant metastasis, and overall survival for all 102 patients was 38%, 94%, 87%, and 88%, respectively. All palpable disease resolved completely after salvage EBRT. The greatest 5-year rate of biochemical control (69%) was obtained in patients with a pre-EBRT PSA level of 0.5 ng/mL or less. The 5-year overall survival rate was significantly better for those who underwent salvage EBRT for a rising PSA level than for those with palpable recurrence (96% versus 78%, P = 0.02). A low pre-EBRT PSA level and a less than 2-year interval from RP to EBRT were independent predictors of biochemical failure. Five patients (5%) experienced chronic grade 3 or 4 RT-related toxicity. CONCLUSIONS: Salvage EBRT provides excellent local control of recurrent disease after RP. Salvage EBRT before the development of palpable local disease may confer a survival benefit and decrease the risk of metastasis, and durable biochemical control was achieved best in those whose pre-EBRT PSA level was 0.5 ng/mL or less. Early referral and careful patient selection is vital for salvage EBRT to be of optimal benefit. SN - 1527-9995 UR - https://www.unboundmedicine.com/medline/citation/15491716/Salvage_radiotherapy_for_men_with_isolated_rising_PSA_or_locally_palpable_recurrence_after_radical_prostatectomy:_do_outcomes_differ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0090-4295(04)00666-1 DB - PRIME DP - Unbound Medicine ER -