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Takahiro Yoshida, Masashi Nakayama, Osamu Suzuki, Kyosuke Matsuzaki, Yasuyuki Kobayashi, Ken Takeda, Yasuyuki Arai, Ken-ichi Kakimoto, Kinji Nishiyama, Kazuo Nishimura, Salvage Radiotherapy for Prostate-specific Antigen Relapse after Radical Prostatectomy for Prostate Cancer: A Single-center Experience, Japanese Journal of Clinical Oncology, Volume 41, Issue 8, August 2011, Pages 1031–1036, https://doi.org/10.1093/jjco/hyr078
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Abstract
The aim of this study was to investigate the efficacy and prognostic factors of salvage radiotherapy for prostate-specific antigen relapse after radical prostatectomy for prostate cancer at a single center in Japan.
A retrospective review of the medical records of 51 patients who underwent salvage radiotherapy for prostate-specific antigen relapse after radical prostatectomy was carried out. Salvage radiotherapy was undergone for the single indication of at least two consecutive prostate-specific antigen elevations >0.1 ng/ml. Salvage radiotherapy was delivered to the prostatic bed at a total dose of 60 or 64 Gy. Late toxicity was scored according to the Common Terminology Criteria for Adverse Events 3.0.
A total dose of 60 and 64 Gy were administered to 26 and 25 patients, respectively. The median prostate-specific antigen level at the initiation of radiotherapy was 0.29 ng/ml (range, 0.11–1.10 ng/ml). With a median follow-up of 57.3 months (range, 9.9–134.0 months), the prostate-specific antigen relapse-free rate at 5 years was 50.7%. Multivariate analysis using Cox's proportional hazards regression model revealed that the Gleason score at radical prostatectomy ≥8 significantly predicted prostate-specific antigen relapse after salvage radiotherapy (hazard ratio 4.531; 95% confidence interval 1.413–14.535; P=0.011). The prostate-specific antigen relapse-free rate at 5 years in the Gleason score at radical prostatectomy ≤7 and at radical prostatectomy ≥8 was 62.7 and 15.4%, respectively.
Salvage radiotherapy was effective for prostate-specific antigen relapse after radical prostatectomy with tolerable toxicities in Japanese patients. A high Gleason score seemed to be a poor prognostic factor.
