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

he removed tissue], PSA doubling time (PSADT) of 10 months or less, and seminal vesicle invasion [cancer spreading to structures near the urinary bladder of males] were significant predictors of disease progression despite salvage radiotherapy. Yet we demonstrated that subsets of patients with high-grade disease and/or a rapid PSADT who were thought to be incurable could still achieve a durable response to salvage radiotherapy when the treatment was administered early in the course of recurrent disease. These results suggest that salvage radiotherapy may prevent metastatic disease progression for those patients at the highest risk," the authors write.

"On the basis of our results, we believe that patients with positive surgical margins who experience relapse after radical prostatectomy should be strongly considered for salvage radiotherapy, even those with high-grade disease and/or a rapid PSADT. We have developed a predictive model to estimate the likelihood of treatment success for a given individual that will help guide physicians in the selection of patients for this therapy," the researchers write. "The clinical implications of our findings are that locally recurrent prostate cancer appears to be more common than previously reported, that it is frequently associated with aggressive features, and that salvage radiotherapy offers the possibility of cure for a substantial proportion of patients with a rapid PSADT and high-grade cancer."

(JAMA. 2004;291:1325-1332. Available post-embargo at JAMA.com) Editor's Note: For information on the funding of this study and the financial disclosures of the authors, please see the JAMA article.


In an accompanying editorial, Mitchell S. Anscher, M.D., of Duke University Medical Center, Durham, N.C., suggests that the most important finding from this study prob

Contact: Kimberlee Barbour
JAMA and Archives Journals

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