ORLANDO, FL USA (UroToday.com) - There are a variety of salvage therapies for failure after RT, the most commonly utilized one is androgen deprivation therapy, used in over 90% of cases, according to CaPSURE data. Local treatment failures can be stratified as; “focal” due to inadequate dose, “margin failure,” “cold spot failure” due to “marginal miss,” or “diffuse failure.” A comparison of cryotherapy vs. salvage prostatectomy published by Pisters, et al. reported three-fold improved cancer outcome with surgery. Pisters concluded that salvage prostatectomy is underutilized and should be considered in carefully selected patients. Salvage brachytherapy under MRI guidance reported that the 4 yr. grade 3-4 toxicity was 30% and 13% required a colostomy, worse when there was a short time period between RT and the salvage brachytherapy.
Dr. Roach concluded that with careful patient selection, in the UCSF experience, patients could have reasonable outcomes in the salvage setting.
Presented by Mack Roach III, MD at the 2011 Genitourinary Cancers Symposium, General Session II: Prostate Cancer Therapy for Recurrent Disease - February 17-19, 2011 - Orlando World Center Marriott, Orlando, Florida USA