Patient Summary: Predicting the outcome of salvage radiotherapy for recurrent prostate cancer after radical prostatectomy
When a patient has a rising PSA after radical prostatectomy, they are often recommended hormone therapy, but this is not without side effects. These investigators wondered if they could predict which patients will respond to salvage radiation therapy without hormonal therapy. They reviewed the records of a large number of patients who underwent salvage radiotherapy. They found that 56% of these patient experienced disease progression after salvage therapy and progression-free survival at 5 and 10 years was 32% and 19% respectively.
Significant variables which played into whether or not the patient relapsed included: pre-radiotherapy PSA, Gleason score, neoadjuvant androgen deprivation (hormone therapy use before surgery), negative surgical margins, PSA at biochemical relapse, PSA doubling time, and regional lymph node metastasis. These factors were used to create a nomogram to predict response to salvage radiotherapy. This is the first model of its kind and it was shown to be quite accurate. It is sure to be published in a scientific journal in the coming months.
The authors also pointed out that early treatment of prostate cancer relapse is associated with an improved outcome; up to 50% of patients are potentially curable if treated when their PSAs are less than or equal to 0.5.