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Radiotherapy for isolated serum prostate specific antigen elevation after prostatectomy for prostate cancer
T M Pisansky1, T F Kozelsky, R P Myers
1Department of Urology, Mayo Clinic, Rochester, Minnesota, USA.
The Journal of Urology
|February 25, 2000
Summary
External beam radiotherapy can help control prostate cancer recurrence after prostatectomy. About half of patients remain relapse-free at 5 years, with few mild complications.
Area of Science:
- Oncology
- Radiation Oncology
- Urology
Background:
- Elevated prostate-specific antigen (PSA) post-prostatectomy indicates prostate cancer recurrence.
- External beam radiotherapy (EBRT) is a treatment option for recurrent prostate cancer.
- Outcomes of EBRT for post-prostatectomy PSA recurrence require further elucidation.
Purpose of the Study:
- To describe intermediate-term outcomes of EBRT in patients with PSA recurrence after prostatectomy.
- To identify pre-therapy factors predicting disease outcome after EBRT.
Main Methods:
- Retrospective study of 166 consecutive patients treated with EBRT (July 1987 - May 1996).
- Kaplan-Meier method used for outcome analysis.
- Statistical associations of pre-therapy variables with outcome were assessed.
Main Results:
- At 5 years, 46% of patients were free of biochemical relapse.
- Independent predictors of relapse included seminal vesicle invasion, tumor grade, and pre-radiotherapy PSA.
- Chronic radiotherapy complications occurred in 16% of patients, often mild.
Conclusions:
- Approximately 50% of patients treated with EBRT for isolated post-prostatectomy PSA elevation achieve biochemical relapse-free status at 5 years.
- EBRT is a viable treatment option with modest long-term morbidity in this setting.