Radiotherapy and Hormonal Therapy Effective for Men with Prostate Cancer Failing Surgery

Researchers from the Mayo Clinic have reported that relapse-free survival was over 90% in patients treated with salvage radiotherapy (RT) plus two years of androgen deprivation therapy (ADT) for post-prostatectomy relapse. The details of this study were presented at the 2009 meeting of the American Society of Therapeutic Radiology and Oncology in the first week in November, 2009.

Previous studies have evaluated RT salvage therapy for men who failed radical prostatectomy. Patients who relapse after radical prostatectomy and receive radiation therapy have a variable prognosis that has been poorly defined in previous studies. In one review the outcomes of 501 men who had recurrent prostate cancer following radical prostatectomy and had received salvage radiation therapy were evaluated. It was reported that 50% of patients treated with salvage therapy after failing prostatectomy were alive without progression of disease with a median follow-up of almost four years. It was also reported that half the patients remained progression-free with a median follow-up of 45 months. Only 4% of patients had died of prostate cancer during this period of observation. In another study, researchers from M. D. Anderson Cancer Center reported that radiation therapy—with or without hormonal therapy—for men with biochemical failure following prostatectomy was effective salvage therapy. They reported that 84% of men with favorable characteristics and 62% with unfavorable characteristics had five-year control of PSA. Researchers from Johns Hopkins University and Duke University have reported that salvage radiotherapy following biochemical recurrence improves prostate cancer-specific survival in men with a PSA doubling time of less than six months.

The current study involved 75 men who had biochemical failure after radical prostatectomy who were treated with RT plus two years of ADT. These patients consisted of two groups:

Group 1: Patients with a PSA relapse alone after having undetectable postoperative levels (n=46)

Group 2: Patients with PSA relapse with clinically palpable or biopsy-proven recurrence (n=26)

The median follow-up in this study was 6.4 years:

All patients achieved undetectable PSA levels.

Relapse-free survival and freedom from PSA relapse was 92% at five years and 79% at seven years.

Relapse-free survival at seven years was 81% for patients in Group 1 and 76% for patients in Group 2.

Survival at seven years was 93% at five and seven years.

There were 13 PSA relapses, with two having distant disease but none with a local clinical recurrence. – CancerConsultants.com