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Treatment Resistant Cancers02:56

Treatment Resistant Cancers

Cancer is the second leading cause of death in the United States. A cancer cell is genetically unstable and hence can mutate faster. They can also modify their microenvironment and escape immune surveillance. The difficulties in treating cancer are further compounded by the emergence of rapid resistance to anticancer drugs. The most common ways to attain resistance in cancer cells include alteration in drug transport and metabolism, modification of drug target, elevated DNA damage response, or...
Treatment Resistent Cancers02:56

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Cancer is the second leading cause of death in the United States. A cancer cell is genetically unstable and hence can mutate faster. They can also modify their microenvironment and escape immune surveillance. The difficulties in treating cancer are further compounded by the emergence of rapid resistance to anticancer drugs. The most common ways to attain resistance in cancer cells include alteration in drug transport and metabolism, modification of drug target, elevated DNA damage response, or...

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Related Experiment Video

Updated: Jul 10, 2026

A Bioluminescent and Fluorescent Orthotopic Syngeneic Murine Model of Androgen-dependent and Castration-resistant Prostate Cancer
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Dose-intensified Versus Conventional-dose Salvage Radiotherapy for Biochemically Recurrent Prostate Cancer After

Pirus Ghadjar1, Stefanie Hayoz2, Daniel R Zwahlen3

  • 1Department of Radiation Oncology, Inselspital, Bern University Hospital, Bern, Switzerland; Department of Radiation Oncology, University of Bern, Bern, Switzerland.

European Urology
|January 6, 2026
PubMed
Summary
This summary is machine-generated.

Higher dose salvage radiotherapy (SRT) after prostate cancer surgery offers no survival benefit and increases gastrointestinal toxicity. Long-term outcomes show conventional-dose SRT is as effective as dose-intensified SRT without added side effects.

Keywords:
Biochemical progressionProstate cancerSalvage radiotherapy

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Area of Science:

  • Oncology
  • Radiation Oncology
  • Urologic Oncology

Background:

  • Salvage radiotherapy (SRT) is a treatment option for men with biochemical progression after radical prostatectomy.
  • The optimal radiation dose for SRT remains under investigation, particularly concerning efficacy and toxicity.
  • Previous studies have explored dose escalation, but long-term data on efficacy and safety are crucial.

Purpose of the Study:

  • To compare long-term outcomes of conventional-dose (64 Gy) versus dose-intensified (70 Gy) SRT in men with biochemical progression post-prostatectomy.
  • To evaluate the impact of dose-intensified SRT on freedom from biochemical progression (FFBP), clinical progression-free survival (PFS), time to hormonal treatment, overall survival (OS), and late toxicity.
  • To determine if dose escalation in SRT provides superior oncological control without compromising patient safety.

Main Methods:

  • A phase 3 randomized trial (SAKK 09/10) assigned 350 men with biochemical progression after radical prostatectomy to either 64 Gy or 70 Gy of SRT to the prostate bed.
  • Patients did not receive hormonal therapy.
  • Primary endpoint was FFBP; secondary endpoints included clinical PFS, time to hormonal treatment, OS, and late toxicity, assessed over a median follow-up of 8.6 years.

Main Results:

  • After a median follow-up of 8.6 years, there was no significant difference in median FFBP between the 64 Gy (8.7 years) and 70 Gy (8.7 years) arms (p=0.87).
  • No significant differences were observed in clinical PFS, time to hormonal treatment, or OS between the two dose groups.
  • Late grade 2 and 3 gastrointestinal toxicity was significantly more frequent in the 70 Gy arm compared to the 64 Gy arm (p=0.015), while genitourinary toxicity did not differ significantly.

Conclusions:

  • Dose-intensified salvage radiotherapy (70 Gy) is not superior to conventional-dose SRT (64 Gy) in terms of long-term oncological outcomes for men with biochemical progression after prostatectomy.
  • Higher-dose SRT is associated with an increased risk of late gastrointestinal toxicity without providing additional oncological benefit.
  • Conventional-dose SRT represents an effective treatment strategy with a more favorable toxicity profile for this patient population.