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Salvage radiotherapy for rising or persistent PSA after radical prostatectomy.

Publication ,  Journal Article
Song, DY; Thompson, TL; Ramakrishnan, V; Harrison, R; Bhavsar, N; Onaodowan, O; DeWeese, TL
Published in: Urology
August 2002

OBJECTIVES: To assess the effectiveness of salvage radiotherapy (RT) for a persistent or rising prostate-specific antigen (PSA) level after radical prostatectomy, and to identify the pretreatment factors that may predict for patients likely to benefit from this treatment. METHODS: Seventy-three consecutive patients were treated during a 10-year period (1989 to 1999) with RT after radical prostatectomy. Twelve patients were excluded from analysis because of either an undetectable PSA level before RT or lack of follow-up data. No patients had clinical or radiographic evidence of distant disease. An undetectable PSA level (less than 0.1 ng/mL) was required to be considered disease free. RESULTS: The median PSA level before RT was 0.8 ng/mL (range 0.1 to 63). The median radiation dose prescribed was 66.6 Gy. The actuarial PSA-free survival rate at 4 years was 39%. Failure was uncommon in patients followed up beyond 4 years. Univariate analysis revealed that a pre-RT PSA level of less than 1.0 ng/mL (P = 0.001), Gleason score less than 8 (P = 0.003), and achievement of an undetectable PSA level after prostatectomy (P = 0.018) were significant predictors of improved disease-free survival. On multivariate analysis, both a pre-RT PSA level of less than 1.0 ng/mL and a Gleason score less than 8 maintained statistical significance. CONCLUSIONS: Salvage RT provides a reasonable chance of intermediate-term disease-free survival in patients with PSA persistence or relapse after radical prostatectomy. Patients with a higher PSA level (greater than 1 ng/mL) and Gleason score of 8 or more are less likely to benefit from this treatment, and improved therapies are needed for this subset of patients. Patients should be referred promptly for salvage RT after detection of relapse.

Duke Scholars

Published In

Urology

DOI

EISSN

1527-9995

Publication Date

August 2002

Volume

60

Issue

2

Start / End Page

281 / 287

Location

United States

Related Subject Headings

  • Urology & Nephrology
  • Salvage Therapy
  • Recurrence
  • Radiotherapy Dosage
  • Prostatic Neoplasms
  • Prostatectomy
  • Prostate-Specific Antigen
  • Male
  • Humans
  • Disease-Free Survival
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Song, D. Y., Thompson, T. L., Ramakrishnan, V., Harrison, R., Bhavsar, N., Onaodowan, O., & DeWeese, T. L. (2002). Salvage radiotherapy for rising or persistent PSA after radical prostatectomy. Urology, 60(2), 281–287. https://doi.org/10.1016/s0090-4295(02)01709-0
Song, Danny Y., Travis L. Thompson, Viswanathan Ramakrishnan, Rachel Harrison, Nrupen Bhavsar, Onajite Onaodowan, and Theodore L. DeWeese. “Salvage radiotherapy for rising or persistent PSA after radical prostatectomy.Urology 60, no. 2 (August 2002): 281–87. https://doi.org/10.1016/s0090-4295(02)01709-0.
Song DY, Thompson TL, Ramakrishnan V, Harrison R, Bhavsar N, Onaodowan O, et al. Salvage radiotherapy for rising or persistent PSA after radical prostatectomy. Urology. 2002 Aug;60(2):281–7.
Song, Danny Y., et al. “Salvage radiotherapy for rising or persistent PSA after radical prostatectomy.Urology, vol. 60, no. 2, Aug. 2002, pp. 281–87. Pubmed, doi:10.1016/s0090-4295(02)01709-0.
Song DY, Thompson TL, Ramakrishnan V, Harrison R, Bhavsar N, Onaodowan O, DeWeese TL. Salvage radiotherapy for rising or persistent PSA after radical prostatectomy. Urology. 2002 Aug;60(2):281–287.
Journal cover image

Published In

Urology

DOI

EISSN

1527-9995

Publication Date

August 2002

Volume

60

Issue

2

Start / End Page

281 / 287

Location

United States

Related Subject Headings

  • Urology & Nephrology
  • Salvage Therapy
  • Recurrence
  • Radiotherapy Dosage
  • Prostatic Neoplasms
  • Prostatectomy
  • Prostate-Specific Antigen
  • Male
  • Humans
  • Disease-Free Survival