Latest Salvage Radiation News
A small study indicates PSA doubling time of 6 months or less is predictive of failure after SRT.
Monday, December 15, 2014
Latest Salvage Radiation News:
"For the study, 388 patients with pT3-4pN0 prostate cancer with positive or negative surgical margins were recruited. After RP, 307 men achieved an undetectable PSA (arms A + B). In 78 patients the PSA remained above thresholds (median 0.6, range 0.05-5.6 ng/mL). Of the latter, 74 consented to receive 66 Gy to the prostate bed, and SRT was applied at a median of 86 days after RP. Clinical relapse-free survival, metastasis-free survival, and overall survival were determined by the Kaplan-Meier method.RESULTS:
Patients with persisting PSA after RP had higher preoperative PSA values, higher tumor stages, higher Gleason scores, and more positive surgical margins than did patients in arms A + B. For the 74 patients, the 10-year clinical relapse-free survival rate was 63%. Forty-three men had hormone therapy; 12 experienced distant metastases; 23 patients died. Compared with men who did achieve an undetectable PSA, the arm-C patients fared significantly worse, with a 10-year metastasis-free survival of 67% versus 83% and overall survival of 68% versus 84%, respectively."
Friday, May 2, 2014
Freie Universität Berlin (Wikimedia Commons)
They found a 55% recurrence rate in salvage radiation (SRT) patients. This confirms several other studies around the world that show in the long term, most salvage radiation patients will show at least biochemical recurrence. (In the short run, it's just the opposite) . However, the study also showed very few prostate cancer deaths during the followup period. And the study confirmed other research since 2004: pre-SRT PSA level is a critical factor in predicting the outcome of salvage radiation. The lower your PSA at the time of salvage radiation, the better. The takeaway? If you're considering salvage radiation, don't dally.
Lohm G, Lütcke J, Jamil B, Höcht S, Neumann K, Hinkelbein W, Wiegel T, Bottke
D. Salvage radiotherapy in patients with prostate cancer and biochemical relapse
after radical prostatectomy : Long-term follow-up of a single-center survey.
Strahlenther Onkol. 2014 Feb 28. [Epub ahead of print] PubMed PMID: 24577132.