Radiation Oncology Journal

The Korean Society for Radiation Oncology (대한방사선종양학회)
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Long-term tolerance and outcomes for dose escalation in early salvage post-prostatectomy radiation therapy

  • Safdieh, Joseph J. (Department of Veteran Affairs, New York Harbor Healthcare System) ;
  • Schwartz, David (Department of Veteran Affairs, New York Harbor Healthcare System) ;
  • Weiner, Joseph (Department of Veteran Affairs, New York Harbor Healthcare System) ;
  • Weiss, Jeffrey P. (Department of Veteran Affairs, New York Harbor Healthcare System) ;
  • Rineer, Justin (University of Florida Health Cancer Center) ;
  • Madeb, Isaac (Department of Veteran Affairs, New York Harbor Healthcare System) ;
  • Rotman, Marvin (Department of Veteran Affairs, New York Harbor Healthcare System) ;
  • Schreiber, David (Department of Veteran Affairs, New York Harbor Healthcare System)
  • Received : 2014.06.27
  • Accepted : 2014.08.21
  • Published : 2014.09.30
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Abstract

Purpose: To study the long-term outcomes and tolerance in our patients who received dose escalated radiotherapy in the early salvage post-prostatectomy setting. Materials and Methods: The medical records of 54 consecutive patients who underwent radical prostatectomy subsequently followed by salvage radiation therapy (SRT) to the prostate bed between 2003-2010 were analyzed. Patients included were required to have a pre-radiation prostate specific antigen level (PSA) of 2 ng/mL or less. The median SRT dose was 70.2 Gy. Biochemical failure after salvage radiation was defined as a PSA level >0.2 ng/mL. Biochemical control and survival endpoints were analyzed using the Kaplan-Meier method. Univariate and multivariate Cox regression analysis were used to identify the potential impact of confounding factors on outcomes. Results: The median pre-SRT PSA was 0.45 ng/mL and the median follow-up time was 71 months. The 4- and 7-year actuarial biochemical control rates were 75.7% and 63.2%, respectively. The actuarial 4- and 7-year distant metastasis-free survival was 93.7% and 87.0%, respectively, and the actuarial 7-year prostate cancer specific survival was 94.9%. Grade 3 late genitourinary toxicity developed in 14 patients (25.9%), while grade 4 late genitourinary toxicity developed in 2 patients (3.7%). Grade 3 late gastrointestinal toxicity developed in 1 patient (1.9%), and grade 4 late gastrointestinal toxicity developed in 1 patient (1.9%). Conclusion: In this series with long-term follow-up, early SRT provided outcomes and toxicity profiles similar to those reported from the three major randomized trials studying adjuvant radiation therapy.

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References

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