Long-term Outcomes of Salvage Radiotherapy for PSA-Recurrent Prostate Cancer: Does It Work?

We know that approximately one-third of all men who elect to have a radical prostatectomy for localized prostate cancer will ultimately experience a biochemical (PSA) recurrence. Researchers at the Department of Urology, Loyola University Medical Center, Maywood, IL, report on their long-term outcomes of salvage radiotherapy (SRT).

Hugen, CM, etal., performed a retrospective chart review of all men treated with SRT following radical prostatectomy for biochemical PSA recurrence at Loyola between 1992 and 2003. They calculated the probability of 6-year biochemical progression-free survival following SRT and performed a goodness-of-fit test to ascertain whether the previously published nomogram correctly predicted our observations.

The researchers concluded that during the study period, 96 men had been treated with SRT. At a median follow-up of 71 months, 44 (46%) had a durable PSA-free response.

They also found that there was no significant difference between the observed progression-free survival and that predicted by the Stephenson nomogram (P = 0.7). Multivariate logistic regression analysis determined that PSA value at the initiation of SRT (P = 0.02) and pathologic Gleason Score (P = 0.04) were significantly associated with the probability of recurrence.

CONCLUSIONS: During the study period, nearly half of the men treated with SRT for PSA recurrence following radical prostatectomy had a durable treatment response. They also found the predictive nomogram developed by Stephenson, et al. to be valid.

So, does SRT work? One half of men who under went the treatment seemed to have benefited from the treatment protocol.

World J Urol. 2010 May 7.