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Radiation therapy alone is not successful as salvage treatment for locally recurrent prostate cancer after radical prostatectomy

Abstract

Purpose/Objectives: To evaluate radiotherapy (XRT) as potential salvage treatment for patients with locally recurrent prostate cancer after redical prostatectomy (RP). Materials and Methods: Twenty-four consecutive patients with adenocarcinoma of the prostate who received definitive XRT between 1987 and 1993 for biopsy-proven (n=18) or for prostate-specific antigen (PSA) - producing (n=6) recurrent disease following RP were evaluated. No patient had clinically or radiographically evident distant disease. Biopsies of suspicious nodules or ultrasound findings in the prostatic fossa were positive in 18 and negative in 3. Three patients had no focal abnormalities and had no biopsy. The time between RP and XRT varied from 6 to 277 months (mean 52 months). XRT doses to the prostatic fossa ranged from 60 to 70 Gy (median, 66 Gy). Outcome was analyzed relative to local control, metastatic disease and PSA status. Persistently undetectable PSA was required to define freedom from disease. Results: Pre-XRT PSA levels ranged from 0.7 to 26.8 ng/ml (mean 7.3 ng/ml, median 2.5 ng/ml). Although PSA fell post-XRT in all but 3 patients and 10 (52%) achieved undetectable levels, the outcome at a median follow-up of 42 months (range 13-90 months) was poor, with 15 patients (63%) developing persistent/progressive disease. The patterns  More>>
Publication Date:
Jul 01, 1995
Product Type:
Journal Article
Resource Relation:
Journal Name: International Journal of Radiation Oncology, Biology and Physics; Journal Volume: 32; Journal Issue: 971; Other Information: Copyright (c) 1995 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved; Country of input: International Atomic Energy Agency (IAEA); PBD: 1995
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; ANTIGENS; BIOLOGICAL INDICATORS; CARCINOMAS; METASTASES; PROSTATE; RADIOTHERAPY; SURGERY; X RADIATION
OSTI ID:
20420773
Country of Origin:
United States
Language:
English
Other Identifying Numbers:
Journal ID: ISSN 0360-3016; IOBPD3; TRN: US03R2015005178
Submitting Site:
INIS
Size:
page(s) 272
Announcement Date:
Feb 11, 2004

Citation Formats

Oas, Lute G, Zagars, Gunar K, and Pollack, Alan. Radiation therapy alone is not successful as salvage treatment for locally recurrent prostate cancer after radical prostatectomy. United States: N. p., 1995. Web. doi:10.1016/0360-3016(95)97923-O.
Oas, Lute G, Zagars, Gunar K, & Pollack, Alan. Radiation therapy alone is not successful as salvage treatment for locally recurrent prostate cancer after radical prostatectomy. United States. doi:10.1016/0360-3016(95)97923-O.
Oas, Lute G, Zagars, Gunar K, and Pollack, Alan. 1995. "Radiation therapy alone is not successful as salvage treatment for locally recurrent prostate cancer after radical prostatectomy." United States. doi:10.1016/0360-3016(95)97923-O. https://www.osti.gov/servlets/purl/10.1016/0360-3016(95)97923-O.
@misc{etde_20420773,
title = {Radiation therapy alone is not successful as salvage treatment for locally recurrent prostate cancer after radical prostatectomy}
author = {Oas, Lute G, Zagars, Gunar K, and Pollack, Alan}
abstractNote = {Purpose/Objectives: To evaluate radiotherapy (XRT) as potential salvage treatment for patients with locally recurrent prostate cancer after redical prostatectomy (RP). Materials and Methods: Twenty-four consecutive patients with adenocarcinoma of the prostate who received definitive XRT between 1987 and 1993 for biopsy-proven (n=18) or for prostate-specific antigen (PSA) - producing (n=6) recurrent disease following RP were evaluated. No patient had clinically or radiographically evident distant disease. Biopsies of suspicious nodules or ultrasound findings in the prostatic fossa were positive in 18 and negative in 3. Three patients had no focal abnormalities and had no biopsy. The time between RP and XRT varied from 6 to 277 months (mean 52 months). XRT doses to the prostatic fossa ranged from 60 to 70 Gy (median, 66 Gy). Outcome was analyzed relative to local control, metastatic disease and PSA status. Persistently undetectable PSA was required to define freedom from disease. Results: Pre-XRT PSA levels ranged from 0.7 to 26.8 ng/ml (mean 7.3 ng/ml, median 2.5 ng/ml). Although PSA fell post-XRT in all but 3 patients and 10 (52%) achieved undetectable levels, the outcome at a median follow-up of 42 months (range 13-90 months) was poor, with 15 patients (63%) developing persistent/progressive disease. The patterns of progression in these 15 were: local 3, metastatic 3, persistent PSA 9. All patients whose PSA was persistently detectable developed a rising PSA profile. The actuarial incidence of freedom from disease at 1, 2, 3 and 4 years was 75%, 43%, 36% and 27% respectively. The only factor correlating to outcome was the pre-XRT PSA level. The 9 patients who remain free of disease had a mean PSA level of 3.6 ng/ml compared to a mean level of 9.6 ng/ml among the 15 who failed (p<0.01). All patients with a pre-XRT level >2.5 ng/ml developed disease relapse, whereas the 4-year freedom from disease in those with levels {<=}2.5 ng/ml was 52%. Eleven of the 15 patients whose disease relapsed after XRT received androgen ablation. Although the majority of patients relapsed, survival at 5 years after XRT was 85% - no different from the expected survival for age-matched men in the general population. Conclusion: Using PSA as a disease endpoint, reveals that radiation therapy rarely salvages patients with apparently localized relapse after radical prostatectomy for adenocarcinoma of the prostate. Patients with indications for XRT after RP are better treated immediately rather than waiting for recurrence.}
doi = {10.1016/0360-3016(95)97923-O}
journal = {International Journal of Radiation Oncology, Biology and Physics}
issue = {971}
volume = {32}
journal type = {AC}
place = {United States}
year = {1995}
month = {Jul}
}