Abstract
BACKGROUND: Postprostatectomy adjuvant or salvage radiotherapy, when using standard fractionation, requires 6.5 to 8 weeks of treatment. The authors report on the safety and efficacy of an expedited radiotherapy course for salvage prostate radiotherapy. METHODS: A total of 108 consecutive patients were treated with salvage radiation therapy to 65 grays (Gy) in 26 fractions of 2.5 Gy. Median follow-up was 32.4 months. Median presalvage prostate-specific antigen (PSA) was 0.44 (range, 0.05-9.50). Eighteen (17%) patients received androgen deprivation after surgery or concurrently with radiation. RESULTS: The actuarial freedom from biochemical failure for the entire group at 4 years was 67% ± 5.3%. An identical 67% control rate was seen at 5 years for the first 50 enrolled patients, whose median follow-up was longer at 43 months. One acute grade 3 genitourinary toxicity occurred, with no acute grade 3 gastrointestinal and no late grade 3 toxicities observed. On univariate analysis, higher Gleason score (P =.006), PSA doubling time ≤12 months (P =.03), perineural invasion (P =.06), and negative margins (P =.06) showed association with unsuccessful salvage. On multivariate analysis, higher Gleason score (P =.057) and negative margins (P =.088) retained an association with biochemical failure. CONCLUSIONS: Hypofractionated radiotherapy (65 Gy in 2.5 Gy fractions in about 5 weeks) reduces the length of treatment by from 1-A to 3 weeks relative to other treatment schedules commonly used, produces low rates of toxicity, and demonstrates encouraging efficacy at 4 to 5 years. Hypofractionation may provide a convenient, resource-efficient, and well-tolerated salvage approach for the estimated 20,000 to 35,000 US men per year experiencing biochemical recurrence after prostatectomy.
Original language | English (US) |
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Pages (from-to) | 2629-2636 |
Number of pages | 8 |
Journal | Cancer |
Volume | 117 |
Issue number | 12 |
DOIs | |
State | Published - Jun 15 2011 |
Keywords
- hypofractionation
- postprostatectomy
- prognostic factors
- prostate cancer
- salvage radiotherapy
ASJC Scopus subject areas
- Oncology
- Cancer Research