Clinical Outcome of Salvage Radiotherapy for Locoregional Clinical Recurrence After Radical Prostatectomyopen access
- Authors
- Lee, Sung Uk; Cho, Kwan Ho; Kim, Jin Ho; Kim, Young Seok; Nam, Taek-Keun; Kim, Jae-Sung; Cho, Jaeho; Choi, Seo Hee; Shim, Su Jung; Kim, Jin Hee; Chang, Ah Ram
- Issue Date
- Nov-2021
- Publisher
- Adenine Press
- Keywords
- prostatic neoplasms; prostatectomy; radiotherapy; recurrence
- Citation
- Technology in Cancer Research and Treatment, v.20, no.0, pp 1 - 7
- Pages
- 7
- Journal Title
- Technology in Cancer Research and Treatment
- Volume
- 20
- Number
- 0
- Start Page
- 1
- End Page
- 7
- URI
- https://scholarworks.bwise.kr/sch/handle/2021.sw.sch/20061
- DOI
- 10.1177/15330338211041212
- ISSN
- 1533-0346
1533-0338
- Abstract
- Objectives: To assess the clinical outcomes of prostate cancer patients treated with salvage radiotherapy (SRT) for locoregional clinical recurrence (CR) after radical prostatectomy (RP). Methods: Records of 60 patients with macroscopic locoregional recurrence after prostatectomy and referrals for SRT were retrospectively investigated in the multi-institutional database. The median radiation dose was 70.2 Gy. Biochemical failure was defined as the prostate-specific antigen (PSA) >= nadir + 2 or initiation of androgen deprivation therapy (ADT) for increased PSA. Results: Median recurrent tumor size was 1.1 cm and pre-radiotherapy PSA level was 0.4 ng/ml. At a median follow-up of 83.1-month after SRT, 7-year biochemical failure-free survival (BCFFS), locoregional failure-free survival (LRFFS), distant metastasis-free survival (DMFS), and overall survival (OS) were 67.0%, 89.7%, 83.6%, and 91.2%, respectively. Higher Gleason's scores were associated with unfavorable BCFFS, DMFS, and OS. Pre-SRT PSA >= 0.5 ng/ml predicted worse BCFFS, LRFFS, and DMFS. In multivariate analyses, a Gleason's score of 8 to 10 was associated with decreased BCFFS (hazard ratio [HR] 3.12, 95% confidence interval [CI] 1.11-8.74, P = .031) and OS (HR 17.72, 95% CI 1.75-179.64, P = .015), and combined ADT decreased the risks of distant metastasis (HR 0.18, 95% CI 0.04-0.92, P = .039). Two patients (3.3%) experienced late grade 3 urinary toxicity. Conclusions: SRT for locoregional CR after RP achieved favorable outcomes with acceptable long-term toxicities. Higher Gleason's scores and pre-radiotherapy PSA level were unfavorable prognostic variables. Combined ADT may decrease the risks of metastases.
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