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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
- 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.
- Subjects :
- Adult
Male
Oncology
Biochemical recurrence
Cancer Research
medicine.medical_specialty
Neoplasm, Residual
Time Factors
Antineoplastic Agents, Hormonal
medicine.medical_treatment
Kaplan-Meier Estimate
Prostate cancer
Risk Factors
Internal medicine
Biomarkers, Tumor
Humans
Medicine
Survival analysis
Aged
Neoplasm Staging
Proportional Hazards Models
Retrospective Studies
Aged, 80 and over
Prostatectomy
Salvage Therapy
Analysis of Variance
business.industry
Proportional hazards model
Prostatic Neoplasms
Androgen Antagonists
Radiotherapy Dosage
Retrospective cohort study
General Medicine
Middle Aged
Prostate-Specific Antigen
medicine.disease
Radiation therapy
Treatment Outcome
Italy
Radiotherapy, Adjuvant
Neoplasm Grading
business
Adjuvant
Subjects
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