Tuesday, January 12, 2010

Salvage RT and ADT Compared: Study

Researchers in South Korea have found that when PSA rises after prostatectomy, treating men first with salvage radiation and then hormone therapy later, if needed, controls PSA in most cases and slows clinical progression, compared to hormone therapy alone.

49% of the patients failed salvage radiation during the study, after an average of 30.7 months. Those patients were then put on ADT. 14% of those patients successfully controlled their PSA with ADT for 20.7 months, leaving 86% who controlled their PSA for over 3 years.

Fast doubling times (less than 3 months) were predictive of RT failure.

Treatment failure and clinical progression after salvage therapy in men with biochemical recurrence after radical prostatectomy: radiotherapy vs androgen deprivation.

Song C, Kim YS, Hong JH, Kim CS, Ahn H.

Departments of Urology and Radiation Oncology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.

This is personally troubling to me on a couple of points--first, my doubling time was very fast--well under 90 days. Secondly, this study reinforces my belief that I'm far from out of the woods. I'm a little under three years out from the end of salvage radiation, just about the point, on average, where men who fail RT see their PSA rise again. Obviously, I need to keep monitoring my PSA. If it begins to rise and the doubling time is as fast as it was before treatment, I should probably not delay hormone therapy.

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