Radiation therapy effective for some patients with recurrent cancer after radical prostatectomy

For men with prostate cancer who have had their prostate removed and later show signs of cancer recurrence, several factors can help predict response to subsequent radiation therapy, according to a study in the March 17 issue of The Journal of the American Medical Association (JAMA).

Approximately 30,000 men annually in the United States will have recurrence of prostate cancer after radical prostatectomy (removal of the prostate), according to background information in the article. Salvage radiotherapy (radiation therapy following prostatectomy) may potentially cure patients whose disease recurs after radical prostatectomy, but previously gathered evidence suggests that it is ineffective in the patients at highest risk of spread of disease.

Principal investigator Kevin M. Slawin, M.D., of Baylor College of Medicine and The Methodist Hospital, Houston, and colleagues conducted a multicenter analysis of the outcome of salvage radiotherapy in a group of patients with recurrence of prostate cancer after radical prostatectomy to identify variables that are associated with an effective response.

The study included 501 patients at 5 U.S. academic centers who received salvage radiotherapy between June 1987 and November 2002 for detectable and increasing prostate-specific antigen (PSA) levels after radical prostatectomy. PSA is a protein that is found in the blood and that is used to detect and monitor prostate cancer.

The researchers found that over an average follow-up of 45 months, 250 patients (50 percent) experienced disease progression after treatment, 49 (10 percent) developed distant metastases, 20 (4 percent) died from prostate cancer, and 21 (4 percent) died from other or unknown causes. The 4-year progression-free probability (PFP) was 45 percent. "In this cohort, a Gleason score [tumor grade] of 8 to 10, preradiotherapy PSA level greater than 2.0 ng/mL, negative surgical margins [no evidence of cancer cells in the edges of t

Contact: Kimberlee Barbour
JAMA and Archives Journals

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