Long-term tolerance and outcomes for dose escalation in early salvage post-prostatectomy radiation therapy.
10.3857/roj.2014.32.3.179
- Author:
Joseph J SAFDIEH
1
;
David SCHWARTZ
;
Joseph WEINER
;
Jeffrey P WEISS
;
Justin RINEER
;
Isaac MADEB
;
Marvin ROTMAN
;
David SCHREIBER
Author Information
1. Department of Veteran Affairs, New York Harbor Healthcare System, Brooklyn, NY, USA. Joseph.Safdieh@downstate.edu
- Publication Type:Original Article
- Keywords:
Dose escalation;
Prostate cancer;
Radiation therapy;
Salvage
- MeSH:
Follow-Up Studies;
Humans;
Medical Records;
Prostate;
Prostate-Specific Antigen;
Prostatectomy;
Prostatic Neoplasms;
Radiotherapy
- From:Radiation Oncology Journal
2014;32(3):179-186
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: To study the long-term outcomes and tolerance in our patients who received dose escalated radiotherapy in the early salvage post-prostatectomy setting. MATERIALS AND METHODS: The medical records of 54 consecutive patients who underwent radical prostatectomy subsequently followed by salvage radiation therapy (SRT) to the prostate bed between 2003-2010 were analyzed. Patients included were required to have a pre-radiation prostate specific antigen level (PSA) of 2 ng/mL or less. The median SRT dose was 70.2 Gy. Biochemical failure after salvage radiation was defined as a PSA level >0.2 ng/mL. Biochemical control and survival endpoints were analyzed using the Kaplan-Meier method. Univariate and multivariate Cox regression analysis were used to identify the potential impact of confounding factors on outcomes. RESULTS: The median pre-SRT PSA was 0.45 ng/mL and the median follow-up time was 71 months. The 4- and 7-year actuarial biochemical control rates were 75.7% and 63.2%, respectively. The actuarial 4- and 7-year distant metastasis-free survival was 93.7% and 87.0%, respectively, and the actuarial 7-year prostate cancer specific survival was 94.9%. Grade 3 late genitourinary toxicity developed in 14 patients (25.9%), while grade 4 late genitourinary toxicity developed in 2 patients (3.7%). Grade 3 late gastrointestinal toxicity developed in 1 patient (1.9%), and grade 4 late gastrointestinal toxicity developed in 1 patient (1.9%). CONCLUSION: In this series with long-term follow-up, early SRT provided outcomes and toxicity profiles similar to those reported from the three major randomized trials studying adjuvant radiation therapy.
