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Urol Int. 2017;99(4):406-413. doi: 10.1159/000481265. Epub 2017 Oct 12.

Combination of Androgen Deprivation Therapy and Salvage Radiotherapy versus Salvage Radiotherapy Alone for Recurrent Prostate Cancer after Radical Prostatectomy.

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1
Department of Urology, Seoul National University, Boramae Medical Center, Seoul, Korea.

Abstract

INTRODUCTION:

To assess the value of androgen deprivation therapy (ADT) on salvage radiotherapy (RT) in post-prostatectomy recurrent prostate cancer patients, we compared the oncologic outcomes between patients receiving RT + ADT and those receiving RT alone.

MATERIALS AND METHODS:

We reviewed the records of patients diagnosed with prostate cancer between 1995 and 2011, including 93 patients who underwent salvage RT and 69 patients who underwent salvage RT + ADT. The ADT-free duration after withdrawal was calculated to verify testosterone recovery.

RESULTS:

Presalvage prostate serum antigen (PSA) was the only significantly different characteristic between the 2 groups (p < 0.001). The ADT-free duration was greater than 6 months in >80% of patients. Presalvage PSA ≥0.6 ng/mL, pathologic stage ≥T3b, and RT + ADT were significantly associated with biochemical progression after salvage treatment. RT + ADT reduced biochemical progression in patients with seminal vesicle invasion or presalvage PSA ≥0.6 ng/mL (p = 0.001) compared to RT alone; biochemical progression-free probability was unchanged in seminal vesicle noninvasive prostate cancer patients with presalvage PSA <0.6 ng/mL (p = 0.541).

CONCLUSIONS:

RT + ADT reduced the risk of biochemical progression after salvage treatment in patients with seminal vesicle invasion or presalvage PSA ≥0.6 ng/mL, but had no effect in patients with seminal vesicle noninvasive disease and presalvage PSA <0.6 ng/mL.

KEYWORDS:

Prostate-specific antigen ; Prostatectomy; Recurrence; Salvage therapy

PMID:
29020683
DOI:
10.1159/000481265
[Indexed for MEDLINE]

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