Salvage radiation therapy following radical prostatectomy. A national Danish study

Abstract

In patients treated for biochemical failure after RP, positive surgical tumour margins and PSA levels ≤0.5 ng/mL at the time of SRT were associated with a favourable outcome. Despite less favourable tumour characteristics, patients receiving SRT and ADT demonstrated improved b-PFS, and in particular, patients with PSA levels >0.2 ng/ml benefitted from additional ADT.

177Lu-PSMA-617 radioligand therapy for a patient with lymph node metastatic prostate cancer

“…According to guidelines, SRT should be started while PSA is <0.5ng/ml [ 2 ]. Previously choline PET/CT rarely gave positive findings while rising PSA levels were so low.…”

“…In this phase of recurrence, conventional imaging do not detect the sites of recurrence. Patients with BCR may be treated with salvage external beam radiotherapy (SRT) with or without androgen deprivation therapy (ADT) [ 1 , 2 ]. Five treatments prolong survival for patients with metastatic castration-resistant (mCR) PC.…”

PSMA diagnostics and treatments of prostate cancer become mature

“…Localized salvage therapies for suspected local failure such as salvage EBRT after RP are most effective during early PSA recurrence. In a Danish national cohort study, salvage EBRT for patients with PSA recurrence after RP undertaken without restaging imaging was effective for approximately half of the patients [ 1 ]. Improving on these results requires identification of men with truly localized or oligometastatic recurrence.…”

Prostate-specific antigen after salvage radiotherapy for postprostatectomy biochemical recurrence predicts long-term outcome including overall survival

“…However, the advantage from early SRT was biggest in patients with more unfavorable pathological features but less pronounced in men with lower-risk profiles [24]. In an observational cohort of 259 patients, a benefit from additional ADT was found in men whose PSA exceeded 0.2 ng/ml [25]. Regarding side effects, such early ADT is controversial.…”