The conditions and outcomes of Japanese patients with prostate cancer who developed PSA failure after radical prostatectomy (RP), and who were treated via salvage radiotherapy (S-RT), were surveyed.
Clinical data on S-RT were gathered in questionnaires completed by facilities participating in the Japanese Radiation Oncology Study Group. S-RT was defined as external-beam radiotherapy delivered to the prostate beds of patients with prostate cancer who had eventually developed PSA failure, although their PSA values had at one stage attained levels < 0.2 ng/ml following RP. Hormonal therapy was combined with S-RT in ∼40% of cases. Outcomes were evaluated in 186 cases treated via S-RT alone. The nadir PSA level after RP, and the level upon initiation of S-RT, were 0.0135 ng/ml and 0.292 ng/ml, respectively. The median period between RP and S-RT was 18.6 months. The median follow-up period was 58 months. The 5-year PSA recurrence-free survival (PRFS) and clinical failure-free survival (CFFS) rates were 50.1% (95% CI: 42.8-57.9%) and 90.1% (95% CI: 86.4-95.7%), respectively. PRFS was significantly superior in patients with PSA values ≤ 0.3 ng/ml upon initiation of S-RT than in those with PSA values >0.3 ng/ml (57.5% vs 40.5%, P = 0.027). In Japan, hormonal therapy is combined with S-RT in ∼40% of cases. The 5-year PRFS and CFFS rates of cases treated via S-RT alone were 50.1% and 90.1%, respectively. A PSA value of 0.3 ng/ml served as a significant cut-off for prediction of PRFS.
Mizowaki T, Aoki M, Nakamura K, Yorozu A, Kokubo M, Karasawa K, Kozuka T, Nakajima N, Sasai K, Akimoto T. Are you the author?
Department of Radiation Oncology and Image-applied Therapy, Graduate School of Medicine, Kyoto University. 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan; Department of Radiology, The Jikei University School of Medicine, 3-25-8 Nishishinbashi, Minato-ku, Tokyo, 105-8461, Japan; Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Umade, Higashi-ku, Fukuoka, 812-8582, Japan; Department of Radiology, National Tokyo Medical Center, 2-5-1 Higashigaoka, Meguro-ku, Tokyo, 152-8902, Japan; Department of Radiation Oncology, Kobe City Medical Center General Hospital, 2-1-1 Minatojimaminamimachi, Chuo-ku, Kobe, 650-0047, Japan; Department of Radiology, Tokyo Metropolitan Cancer and Infectious diseases Center, Komagome Hospital, 3-18-22 Honkomagome, Bunkyo-ku, Tokyo, 113-8677, Japan; Department of Radiation Oncology, Cancer Institute Hospital, 3-8-31 Ariake, Kouto-ku, Tokyo, 135-8550, Japan; Department of Radiology, Shizuoka General Hospital, 4-27-1 Kitaando, Aoi-ku, Shizuoka, 420-8527, Japan; Department of Radiology, Juntendo University School of Medicine, 3-1-3 Hongo, Bunkyo-ku, Tokyo, 113-8431, Japan; Department of Radiation Oncology and Particle Therapy, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa City, Chiba, 277-8577, Japan.
Reference: J Radiat Res. 2015 Apr 24. pii: rrv027.