Salvage radiotherapy for palpable, locally recurrent prostate cancer after radical prostatectomy

O. Kenneth Macdonald, Steven E. Schild, Sujay A. Vora, Paul E. Andrews, Robert G. Ferrigni, Donald E. Novicki, Scott K. Swanson, William W. Wong

Research output: Contribution to journalArticle

29 Scopus citations

Abstract

Purpose A retrospective study to evaluate the outcome of salvage radiotherapy (RT) for clinically apparent, palpable prostate cancer recurrence after radical prostatectomy (RP). Methods and materials Forty-two patients underwent RT for clinically apparent recurrent prostate cancer after RP between 1993 and 1999. The end points and treatment variables of biochemical disease-free survival were evaluated statistically. Results The median follow-up was 4.3 years. All 42 patients experienced resolution of clinically detectable recurrence within 1 year after RT. The 5-year biochemical disease-free survival, local control, freedom from distant metastases, and overall survival rate was 27%, 94%, 82%, and 78%, respectively. The initial pathologic stage (T3 or T4; p = 0.04) and interval (<2 years from RP to RT; p = 0.01) were independent predictors of biochemical failure, and RT simulation without contrast (p = 0.05) was nearly significant on multivariate analysis. Three patients (7%) experienced chronic Grade 3 or 4 RT-related toxicity. Conclusion Salvage prostate bed RT for clinically apparent locally recurrent prostate cancer after RP provides effective local tumor control with modest durable biochemical control. Patients irradiated with a better simulation technique were found to have a more favorable outcome. A consensus on a definition of biochemical disease-free survival after salvage RT is critical for meaningful comparison of the available data and to future progress in treating this disease process.

Original languageEnglish (US)
Pages (from-to)1530-1535
Number of pages6
JournalInternational Journal of Radiation Oncology Biology Physics
Volume58
Issue number5
DOIs
StatePublished - Apr 1 2004

Keywords

  • Prostate neoplasm
  • Prostatectomy
  • Recurrence
  • Salvage radiotherapy

ASJC Scopus subject areas

  • Radiation
  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Cancer Research

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    Macdonald, O. K., Schild, S. E., Vora, S. A., Andrews, P. E., Ferrigni, R. G., Novicki, D. E., Swanson, S. K., & Wong, W. W. (2004). Salvage radiotherapy for palpable, locally recurrent prostate cancer after radical prostatectomy. International Journal of Radiation Oncology Biology Physics, 58(5), 1530-1535. https://doi.org/10.1016/j.ijrobp.2003.09.082