Adjuvant Radiation Shows Benefit After Prostate Surgery-- Eric Metcalf
Friday, January 23, 2009
FRIDAY, Jan. 23 (HealthDay News) -- Adjuvant radiotherapy shortly after radical prostatectomy in men with extraprostatic prostate cancer is associated with improved survival, according to research released online Jan. 22 in advance of publication in the March issue of the Journal of Urology.
Ian M. Thompson, M.D., of the University of Texas Health Science Center at San Antonio, and colleagues analyzed data from 425 men with pT3N0M0 prostate cancer who were randomized to receive adjuvant radiotherapy or observation after radical prostatectomy. However, one-third in the observation group underwent salvage radiotherapy, generally prompted by prostate specific antigen (PSA) value or objective recurrence. Median follow-up was roughly 12.6 years.
The radiotherapy group had significantly better metastasis-free survival than the observation group (93 events versus 114 events, for a hazard ratio of 0.71), and this group also had significantly better survival (88 deaths versus 110 deaths, for a hazard ratio of 0.72), the researchers report.
"For many if not most clinicians who face the patient with evidence of extraprostatic disease and in whom postoperative PSA is undetectable, a common strategy is simply to follow the PSA and initiate radiotherapy when PSA becomes detectable or before the achievement of some PSA threshold (e.g., 1.5 ng/mL). These data indicate that the salvage radiotherapy approach may place the patient at a higher risk of metastasis and death," the authors write.
Thompson disclosed relationships with Veridex, Mission, and AstraZeneca.
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