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Adjuvant and salvage radiotherapy after prostatectomy: outcome analysis of 307 patients with prostate cancer

Adjuvant and salvage radiotherapy after prostatectomy: outcome analysis of 307 patients with prostate cancer

Authors :
S. Cassani
Beatrice Detti
T. Tony Cai
Alberto Lapini
Donata Villari
Lorenzo Livi
Maurizio Pertici
Giulio Nicita
Silvia Scoccianti
Marco Carini
Giampaolo Biti
Samantha Cipressi
I. Giacomelli
Marco Ceroti
Calogero Saieva
Source :
Journal of Cancer Research and Clinical Oncology. 139:147-157
Publication Year :
2012
Publisher :
Springer Science and Business Media LLC, 2012.

Abstract

In men with adverse pathology after radical prostatectomy, the most appropriate timing to administer radiotherapy (RT) remains a topic of debate. We analyzed in terms of efficacy, prognostic factors and toxicity the two therapeutic strategies: immediate postoperative radiotherapy (PORT) and salvage radiotherapy (SART). Between January 1995 and November 2010, 307 patients underwent adjuvant or salvage radiotherapy, after prostatectomy. In the PORT group, 42 patients (20.7 %) had biochemical failure, with a median time to biochemical failure of 1.8 years; two parameters (age at diagnosis and PSA pre-RT) resulted to be significant at the survival analysis for overall survival (p = 0.003 and p = 0.046, respectively). In the SART group, 33 patients (31.7 %) had biochemical relapse; sixteen patients died of prostate cancer; postoperative hormones therapy, conformal radiotherapy and level of PSA pre-RT >1.0 ng/ml resulted to be significant at the survival analysis, p = 0.009, p = 0.039 and p = 0.002, respectively. Our study is limited by its retrospective and nonrandomized design. As such, decisions to treat with adjuvant or salvage radiotherapy and the time to initiate therapy were based on patient preference and physician counseling. Our recommendation is to suggest adjuvant radiotherapy for all patients with adverse prognostic factors and to reserve salvage radiotherapy for low-risk patients, when the biochemical recurrence occurs.

Details

ISSN :
14321335 and 01715216
Volume :
139
Database :
OpenAIRE
Journal :
Journal of Cancer Research and Clinical Oncology
Accession number :
edsair.doi.dedup.....23e4b6bb5be79baea1f5f11e59aa8ced
Full Text :
https://doi.org/10.1007/s00432-012-1309-9