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Efficacy of salvage radiotherapy plus 2-year androgen suppression for postradical prostatectomy patients with PSA relapse.
Int J Radiat Oncol Biol Phys. 2009 Nov 15; 75(4):983-9.IJ

Abstract

PURPOSE

To determine the efficacy of a combined approach of radiotherapy (RT) plus 2-year androgen suppression (AS) as salvage treatment for prostate-specific antigen (PSA) relapse after radical prostatectomy (RP).

METHODS AND MATERIALS

Seventy-five patients with PSA relapse after RP were treated with salvage RT plus 2-year AS, as per a pilot, prospective study. AS started within 1 month after completion of salvage RT and consisted of nilutamide for 4 weeks and buserelin acetate depot subcutaneously every 2 months for 2 years. Relapse-free rate including freedom from PSA relapse was estimated using the Kaplan-Meier method. PSA relapse was defined as a PSA rise above 0.2 ng/mL with two consecutive increases over a minimum of 3 months. A Cox regression analysis was performed to evaluate prognostic factors for relapse.

RESULTS

Median age of the cohort was 63 years at the time of salvage RT. Median follow-up from salvage RT was 6.4 years. All achieved initially complete PSA response (< 0.2) with the protocol treatment. Relapse-free rate including the freedom from PSA relapse was 91.5% at 5 years and 78.6% at 7 years. Overall survival rate was 93.2% at both 5 and 7 years. On Cox regression analysis, pT3 stage and PSA relapse less than 2 years after RP were significant prognostic factors for relapse.

CONCLUSION

The combined treatment of salvage RT plus 2-year AS yielded an encouraging result for patients with PSA relapse after RP and needs a confirmatory study.

Authors+Show Affiliations

Mayo Clinic, Department of Radiation Oncology, Rochester, MN 55905, USA. choo.c@mayo.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial, Phase I
Clinical Trial, Phase II
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19409726

Citation

Choo, Richard, et al. "Efficacy of Salvage Radiotherapy Plus 2-year Androgen Suppression for Postradical Prostatectomy Patients With PSA Relapse." International Journal of Radiation Oncology, Biology, Physics, vol. 75, no. 4, 2009, pp. 983-9.
Choo R, Danjoux C, Gardner S, et al. Efficacy of salvage radiotherapy plus 2-year androgen suppression for postradical prostatectomy patients with PSA relapse. Int J Radiat Oncol Biol Phys. 2009;75(4):983-9.
Choo, R., Danjoux, C., Gardner, S., Morton, G., Szumacher, E., Loblaw, D. A., Cheung, P., & Pearse, M. (2009). Efficacy of salvage radiotherapy plus 2-year androgen suppression for postradical prostatectomy patients with PSA relapse. International Journal of Radiation Oncology, Biology, Physics, 75(4), 983-9. https://doi.org/10.1016/j.ijrobp.2008.12.049
Choo R, et al. Efficacy of Salvage Radiotherapy Plus 2-year Androgen Suppression for Postradical Prostatectomy Patients With PSA Relapse. Int J Radiat Oncol Biol Phys. 2009 Nov 15;75(4):983-9. PubMed PMID: 19409726.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Efficacy of salvage radiotherapy plus 2-year androgen suppression for postradical prostatectomy patients with PSA relapse. AU - Choo,Richard, AU - Danjoux,Cyril, AU - Gardner,Sandra, AU - Morton,Gerard, AU - Szumacher,Ewa, AU - Loblaw,D Andrew, AU - Cheung,Patrick, AU - Pearse,Maria, Y1 - 2009/05/04/ PY - 2008/09/03/received PY - 2008/11/24/revised PY - 2008/12/18/accepted PY - 2009/5/5/entrez PY - 2009/5/5/pubmed PY - 2009/11/17/medline SP - 983 EP - 9 JF - International journal of radiation oncology, biology, physics JO - Int. J. Radiat. Oncol. Biol. Phys. VL - 75 IS - 4 N2 - PURPOSE: To determine the efficacy of a combined approach of radiotherapy (RT) plus 2-year androgen suppression (AS) as salvage treatment for prostate-specific antigen (PSA) relapse after radical prostatectomy (RP). METHODS AND MATERIALS: Seventy-five patients with PSA relapse after RP were treated with salvage RT plus 2-year AS, as per a pilot, prospective study. AS started within 1 month after completion of salvage RT and consisted of nilutamide for 4 weeks and buserelin acetate depot subcutaneously every 2 months for 2 years. Relapse-free rate including freedom from PSA relapse was estimated using the Kaplan-Meier method. PSA relapse was defined as a PSA rise above 0.2 ng/mL with two consecutive increases over a minimum of 3 months. A Cox regression analysis was performed to evaluate prognostic factors for relapse. RESULTS: Median age of the cohort was 63 years at the time of salvage RT. Median follow-up from salvage RT was 6.4 years. All achieved initially complete PSA response (< 0.2) with the protocol treatment. Relapse-free rate including the freedom from PSA relapse was 91.5% at 5 years and 78.6% at 7 years. Overall survival rate was 93.2% at both 5 and 7 years. On Cox regression analysis, pT3 stage and PSA relapse less than 2 years after RP were significant prognostic factors for relapse. CONCLUSION: The combined treatment of salvage RT plus 2-year AS yielded an encouraging result for patients with PSA relapse after RP and needs a confirmatory study. SN - 1879-355X UR - https://www.unboundmedicine.com/medline/citation/19409726/Efficacy_of_salvage_radiotherapy_plus_2_year_androgen_suppression_for_postradical_prostatectomy_patients_with_PSA_relapse_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0360-3016(09)00013-3 DB - PRIME DP - Unbound Medicine ER -