Radical postprostatectomy irradiation
Preliminary results
Keywords:
PROSTATE NEOPLASMS, RADIOTHERAPY, PROSTATECTOMYAbstract
Introduction: the results of post-radical prostatectomy irradiation for prostate cancer were studied.
Method: 131 consecutive patients treated between 1994 and 2004 were analyzed. Thirty-eight patients underwent adjuvant irradiation for presenting high risk factors for postoperative local recurrence , and 93 due to biochemical relapses after surgery (59 of them presented a palpable relapse in the pelvis).
Results: the actuarial survival free of biochemical relapse, the specific cause survival and the global survival at five years after irradiation were 90%, 100%, and 97% for patients treated with adjuvant radiation therapy, and 65%, 95%, and 90% for patients treated with salvage radiation therapy, respectively. In the latter, when associated hormonal therapy has not been used, the verification of a decrease in the level of prostate specific antigen (PSA) at 50 Gy leads to better biochemical control. Late urinary complications were more frequent than when only radiotherapy was used as initial radical treatment.
Conclusions: the results obtained confirm the trends observed in a previous preliminary publication on the benefits of post-prostatectomy radiotherapy.
References
(2) Cox DR. Regression models and life tables. J R Stat Soc 1972; 34(B): 187-200.
(3) American Society for Therapeutic Radiology and Oncology Consensus Panel. Consensus statement: guidelines for PSA following radiation therapy. Int J Radiat Oncol Biol Phys 1997; 37: 1035-41.
(4) Thames H, Kuban D, Levy L, Horwitz E, Kupelian P, Martinez A. Comparison of alternative biochemical failure definitions based on clinical outcome in 4839 prostate cancer patients treated by external beam radiotherapy between 1986 and 1995. Int J Radiat Oncol Biol Phys 2003; 57: 929-43.
(5) Kaplan E, Meier P. Non parametric estimation from incomplete observations. J Am Stat Assoc 1958; 53: 457-81.
(6) Mantel N. Evaluation of survival data and two new rank order statistics arising in its consideration. Cancer Chemother Rep 1966; 50: 163-70.
(7) Storey M, Pollack A, Zagars G, Smith L, Antolak J, Rosen I. Complications from radiotherapy dose escalation in prostate cancer: preliminary results of a randomized trial. Int J Radiat Oncol Biol Phys 2000; 48: 635-42.
(8) Leborgne F, Leborgne JH, Zubizarreta E, Ortega B, Leborgne Deus J, Leborgne F, et al. Cáncer localizado de próstata: Experiencia de diez años con radioterapia conformal tridimensional. Rev Med Urug 2004; 20: 193-201.
(9) King C, Presti J, Gill H, Brooks J, Hancock S. Radiotherapy after radical prostatectomy: does transient androgen suppression improve outcomes?. Int J Radiat Oncol Biol Phys 2004; 59: 341-7.
(10) Macdonald O, Schild S, Vora S, Andrews P, Ferrigni R, Novicki D, et al. Salvage radiotherapy for palpable, locally recurrent prostate cancer after radical prostatectomy. Int J Radiat Oncol Biol Phys 2004; 58: 1530-5.
(11) Bianco FJ, Scardino PT, Stephenson AJ, Di Biaso CJ, Fearn PA, Eastham JA. Long-term oncologic results of salvage radical prostatectomy for locally recurrent prostate cancer after radiotherapy. Int J Radiat Oncol Biol Phys 2005; 62: 448-53.
(12) Do T , Giatri Dave G, Parker R, Kagan R. Serum PSA evaluations during salvage radiotherapy for post-prostatectomy biochemical failures as prognosticators for treatment outcomes. Int J Radiat Oncol Biol Phys; 2001; 50: 1220-5.
(13) Collie AC, Buskirk SJ, Wehle MJ, Young PR, Petrou SP, Broderick GA, et al. Evaluation of chronic toxicity following radiation therapy for patients with a rising PSA status post prostatectomy. Int J Radiat Oncol Biol Phys 2004; 60: S478.
(14) Maier J, Forman J, Tekyi-Mensah S, Bolton S, Patel R, Pontes J. Salvage radiation for rising PSA following radical prostatectomy. Urol Oncol 22; 2004: 50-6.
