Wednesday, February 13, 2013

Latest Salvage Radiation News

A small, in-house study from the Graduate School of Medicine in Kyoto, Japan found multiple, independent risk factors for recurrence after salvage radiation (SRT). These were:

  • Gleason at or above 8
  • PSA nadir (low point) after SRT at or above 0.04 ng/ml
  • Negative surgical margins
They found that 77.8% of patients in their study with zero risk factors were free of PSA progression five years later.  50% of patients with one risk factor were progression-free, and only 6.7% of patients with two or three risk factors were progression-free at the 5 year mark. 

In my own case, I was okay on the Gleason and surgical margins, but I don't know my PSA nadir to that level of specificity. 

This was an interesting little study, but I trust Andrew Stephenson's much larger one a lot more.

Kyoto blossoms. Photo: jmurawski  Creative Commons license.

2 comments:

John Brydels said...



Gleason at or above 8
PSA nadir (low point) after SRT at or above 0.04 ng/ml
Negative surgical margins

i am confused. don't you mean positive surgical margins? why would negative surgical margins be a risk factor? positive is bad, right?

Replicant said...

John, sorry, I just saw your comment. I'm a little lax these days with this blog, as prostate cancer increasing diminishes in my rear view mirror.
You raise a good question. Normally, you want to have negative (clear) margins. But when your PSA is rising after surgery, positive margins provide a local (and thus still treatable) explanation for the rising PSA. On the other hand, if your PSA is rising after surgery and your margins were negative, it's less likely that your cancer is still confined to the prostate bed, and more likely that it is distant, and may not respond to salvage radiation.