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Strahlenther Onkol. 2015 Oct;191(10):801-9. doi: 10.1007/s00066-015-0872-9. Epub 2015 Jul 10.

Elective pelvic versus prostate bed-only salvage radiotherapy following radical prostatectomy: A propensity score-matched analysis.

Author information

1
Department of Radiation Oncology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 82, Gumi-ro 173 beon-gil, Bundang-gu, Seongnam-si, 463-707, Seongnam, Korea/Republic of Korea.
2
Department of Radiation Oncology, Dongnam Institute of Radiological and Medical Sciences, Busan, Korea.
3
Department of Radiation Oncology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 82, Gumi-ro 173 beon-gil, Bundang-gu, Seongnam-si, 463-707, Seongnam, Korea/Republic of Korea. jskim@snubh.org.
4
Department of Urology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.

Abstract

PURPOSE:

To compare the impact of elective whole pelvic radiotherapy (WPRT) versus prostate bed-only radiotherapy (PBRT) on biochemical relapse-free survival (bRFS) in prostate cancer patients treated with salvage radiotherapy following radical prostatectomy (RP).

PATIENTS AND METHODS:

In our database, 163 lymph node-negative prostate cancer patients who had undergone salvage radiotherapy (SRT) for biochemical relapse after RP between September 2004 and April 2012 were identified. PBRT was administered to 134 patients (the PBRT group), while the remaining 29 patients (the WPRT group) received WPRT.

RESULTS:

Median follow-up was 57 months (range 18-122 months). In the propensity score-matched cohort, the 4-year bRFS of the WPRT group was significantly higher compared to the PBRT group (63.1 vs. 43.4%, p = 0.034). Subgroup analysis showed that the bRFS of patients who had two or more risk factors (seminal vesicle invasion, Roach score for lymph node invasion ≥ 45%, and number of harvested lymph nodes ≤ 5) and were treated with WPRT was significantly improved compared to those who received PBRT (hazard ratio, HR 0.33; 95% confidence interval, CI 0.13-0.83; p = 0.018).

CONCLUSION:

Elective WPRT for SRT may improve bRFS in patients with unfavorable risk factors. These results need to be confirmed by a prospective randomized trial.

KEYWORDS:

Androgen deprivation therapy; Lymph nodes; Prostate cancer; Risk factors; Survival

PMID:
26159555
DOI:
10.1007/s00066-015-0872-9
[Indexed for MEDLINE]

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