The efficacy of postprostatectomy radiotherapy in patients with an isolated elevation of serum prostate-specific antigen

Wu, Justin J.; S, King; Montana, Gustavo S.; McKinstry, Craig A.; Anscher, Mitchell S.

doi:10.1016/0360-3016(95)00083-b

Cited by 104 publications

(52 citation statements)

References 16 publications

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“…as salvage therapy for patients who have a local recurrence confirmed on biopsy or on PSA velocity, or as adjuvant therapy for patients with adverse pathology. In studies with a long follow-up the 3-year biochemical progression-free survival is 24-67% (51% in the present study) and the 5-year biochemical progression-free survival 10-88% (Table 4) [8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23].…”

Section: Discussionmentioning

confidence: 75%

“…Taken together, these studies indicate that whereas pelvic RT after RP can control local disease, the survival outcome is dominated by the probability of developing metastatic disease. The association of hormonal therapy and RT was proposed to most of our patients because they had a high risk of recurrence, and because this association was suggested by several published studies [5,8,9,12]. Only a few studies have investigated the predictive factors for local recurrence after RP (Table 4).…”

Section: Discussionmentioning

confidence: 99%

“…Because some factors could be interdependent, multivariate analysis was used to determine which variable retained significance (Table 3) [4][5][6][7][8][9]. This analysis showed that only Gleason score ( P = 0.0395) and nadir serum PSA after RT ( P = 0.028) were independent predictive factors of salvage/adjuvant RT.…”

Section: Predictive Factors For Biochemical Progressionmentioning

confidence: 99%

“…For patients with presumed local recurrence or persistent prostate cancer based on PSA velocity or adverse pathology, radiation therapy (RT) as an adjuvant or a salvage treatment has been reported as a therapeutic option, with several studies publishing the outcome [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23]. However, only a few studies tried to identify the predictive factors of biochemical progression in patients with PSA recurrence after RP and treated with RT [4][5][6][7][8][9].…”

Section: Introductionmentioning

confidence: 99%

“…However, only a few studies tried to identify the predictive factors of biochemical progression in patients with PSA recurrence after RP and treated with RT [4][5][6][7][8][9]. We reviewed retrospectively our experience of salvage RT after RP and tried to define the best candidates for this therapeutic option, based on our experience and a literature review.…”

Section: Introductionmentioning

confidence: 99%

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Predictive factors of radiation therapy for patients with prostate specific antigen recurrence after radical prostatectomy

Taille¹,

Flam²,

Thiounn³

et al. 2002

BJU International

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Objectives To assess the efficacy of salvage/adjuvant radiation therapy (RT) for patients with prostate-specific antigen (PSA) recurrence after radical prostatectomy (RP). Between 1997 and 2001, 52 patients were treated in our institution with RT for PSA recurrence after RP. The mean (range) delay between RP and RT was 30.5 (0.16-105.6) months. Eighteen patients received no hormonal therapy before RT. The failure of RT was defined as three consecutive increases in PSA levels with intervals of ≥ 6 weeks. Results Within a mean (range) follow-up of 27.7 (6-69) months, 18 patients presented with biochemical progression. The 3-year biochemical progression-free survival was 51%. Using univariate analysis, an age < 65 years ( P = 0.0262), a Gleason score on the RP specimen of ≥ 8 ( P = 0.0024), stage pT3 ( P = 0.02), a detectable nadir PSA after RT ( P < 0.001) and the absence of hormonal therapy ( P = 0.0359) were associated with a lower biochemical progression-free survival. However, only the Gleason score ( P = 0.0395) and nadir serum PSA after RT ( P = 0.028) remained independent predictive factors on multivariate analysis. Conclusion Half of the present patients treated with RT for an isolated high serum PSA level after RP were free of biochemical relapse at 3 years of follow-up. RT may be proposed to selected patients with mild morbidity. However, definitive evidence of the beneficial effect of adjuvant RT for patients with PSA recurrence after RP awaits the conclusion of randomized clinical trials. Patients and methods

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Section: Discussionmentioning

confidence: 75%

Section: Discussionmentioning

confidence: 99%

Section: Predictive Factors For Biochemical Progressionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Predictive factors of radiation therapy for patients with prostate specific antigen recurrence after radical prostatectomy

Taille¹,

Flam²,

Thiounn³

et al. 2002

BJU International

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Salvage Radiotherapy for Recurrent Prostate Cancer After Radical Prostatectomy

Stephenson¹

2004

JAMA

590

323

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Context Salvage radiotherapy may potentially cure patients with disease recurrence after radical prostatectomy, but previous evidence has suggested that it is ineffective in patients at the highest risk of metastatic disease progression. Objective To delineate patients who may benefit from salvage radiotherapy for prostate cancer recurrence by identifying variables associated with a durable response. Design, Setting, and Patients Retrospective review of a cohort of 501 patients at 5 US academic tertiary referral centers who received salvage radiotherapy between June 1987 and November 2002 for detectable and increasing prostate-specific antigen (PSA) levels after radical prostatectomy. Main Outcome Measure Disease progression after salvage radiotherapy, defined as a serum PSA value Ն0.1 ng/mL above the postradiotherapy PSA nadir confirmed by a second PSA measurement that was higher than the first by any amount, by a continued increase in PSA level after treatment, or by the initiation of androgen deprivation therapy after treatment. Results Over a median follow-up of 45 months, 250 patients (50%) experienced disease progression after treatment, 49 (10%) developed distant metastases, 20 (4%) died from prostate cancer, and 21 (4%) died from other or unknown causes. The 4-year progression-free probability (PFP) was 45% (95% confidence interval [CI], 40%-50%). By multivariable analysis, predictors of progression were Gleason score of 8 to 10 (hazard ratio [

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Salvage Radiotherapy for Recurrent Prostate Cancer

Anscher¹

2004

JAMA

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The efficacy of postprostatectomy radiotherapy in patients with an isolated elevation of serum prostate-specific antigen

Cited by 104 publications

References 16 publications

Predictive factors of radiation therapy for patients with prostate specific antigen recurrence after radical prostatectomy

Predictive factors of radiation therapy for patients with prostate specific antigen recurrence after radical prostatectomy

Salvage Radiotherapy for Recurrent Prostate Cancer After Radical Prostatectomy

Salvage Radiotherapy for Recurrent Prostate Cancer

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