Proposed salvage treatment strategy for biochemical failure after radical prostatectomy in patients with prostate cancer: a retrospective study

Radiation Oncology

Kiyohide Fujimoto¹  Noboru Konishi³  Masatoshi Hasegawa²  Tatsuo Yoneda¹  Katsuya Aoki¹  Kazumasa Torimoto¹  Satoshi Anai¹  Yosuke Morizawa¹  Isao Asakawa²  Nobumichi Tanaka¹  Makito Miyake¹ 

[1] Department of Urology, Nara Medical University, 840 Shijo-cho, Nara 634-8522, Japan;Department of Radiation Oncology, Nara Medical University, 840 Shijo-cho, Nara 634-8522, Japan;Department of Pathology, Nara Medical University, 840 Shijo-cho, Nara 634-8522, Japan

关键词: PSA velocity;    PSA doubling time;    Prostate-specific antigen;    Salvage radiotherapy;    Biochemical failure;    Prostate cancer;   

Others  :  1151140
DOI  :  10.1186/1748-717X-9-208

 received in 2014-07-10, accepted in 2014-08-16,  发布年份 2014

【 摘 要 】

Background

Treatment options for patients with recurrent disease after radical prostatectomy include salvage radiotherapy of the prostatic bed and/or androgen deprivation therapy. To establish an effective treatment strategy for recurrent disease after radical prostatectomy, we retrospectively analyzed the outcome of salvage radiation monotherapy in such cases.

Methods

Data from 61 men who had undergone salvage radiation monotherapy for biochemical recurrent disease after radical prostatectomy were retrospectively reviewed. In all patients, salvage radiotherapy consisted of iraradiation to the prostatic bed (70 Gy) using three-dimensional conformal radiotherapy techniques. Treatment outcome was analyzed to identify predictive factors of salvage radiotherapy.

Results

The biochemical recurrence-free survival after salvage radiation monotherapy at 2 and 5 years was 55% and 38%, respectively. Cox proportional regression models revealed that the independent predictive factors for biochemical recurrence were Gleason Score ≥ 8, negative surgical margin, and PSA velocity ≥ 0.38 ng/mL/year. Negative surgical margin and PSA velocity ≥ 0.8 ng/mL/year were significantly associated with poor response in the serum PSA levels after salvage radiotherapy.

Conclusions

Based on our findings, we propose a treatment strategy for biochemical recurrent disease after radical prostatectomy. Patients with Gleason score ≤ 7, positive surgical margin, and PSA velocity < 0.38 ng/mL/year are categorized the most favorable group, so that eradication by salvage radiation monotherapy could be expected. Other patients could be divided to two groups depending on surgical margin status and PSA velocity: 1) patients who might require combination of SRT and short-term androgen deprivation therapy and 2) patients who should be treated by androgen deprivation monotherapy.

【 授权许可】

   
2014 Miyake et al.; licensee BioMed Central Ltd.

【 图 表 】

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