title: Outcome, morbidity, and prognostic factors in post-prostatectomy radiotherapy: an Australian multicenter study.
abstract: OBJECTIVE
  To report the outcome and morbidity data for patients treated with post-prostatectomy radiotherapy (PPRT) in a multicenter collaboration.
  
  
  METHODS
  The case records of all patients treated with PPRT from 1996 to 1998 were reviewed. Survival was calculated using Kaplan-Meier methods. Potential prognostic factors were evaluated using the Cox proportional hazards regression model. Prostate-specific antigen (PSA) remission was defined as a PSA level of 0.2 ng/mL or less. Acute and late morbidities were documented.
  
  
  RESULTS
  We reviewed the data of 115 patients, with a median follow-up from the start of PPRT of 28.7 months. Patients were treated with adjuvant intent (n = 23), for local recurrence (n = 27), or for a detectable PSA level (n = 65). The overall and cause-specific survival rate at 5 years was 73.7% and 81.4%, respectively. The biochemical disease-free survival rate was 69.6% at 2 years and 50% at 5 years. Factors predicting for subsequent relapse on multivariate analysis were pre-PPRT PSA (P = 0.013) and post-PPRT nadir (P <0.0001). Patients with a PSA greater than 1 ng/mL fared significantly worse than those with lower levels (P <0.0001). For patients with a pretreatment PSA of less than 1 ng/mL and an operative Gleason score of 7 or less, the 5-year projected biochemical disease-free survival rate was 71%. One case of grade 3 late proctitis was recorded, and 4 patients had continued grade 3 late urinary incontinence.
  
  
  CONCLUSIONS
  Early use of PPRT is effective and well tolerated in patients at risk of, or with proven, local recurrence.
authors.affiliation: Division of Radiation Oncology, Alfred Hospital, Melbourne, Australia.
authors.forename: Gillian M
authors.initials: GM
authors.lastname: Duchesne
authors.forename: Caroline
authors.initials: C
authors.lastname: Dowling
authors.forename: Mark
authors.initials: M
authors.lastname: Frydenberg
authors.forename: David
authors.initials: D
authors.lastname: Joseph
authors.forename: N Kumar
authors.initials: NK
authors.lastname: Gogna
authors.forename: Greg
authors.initials: G
authors.lastname: Neerhut
authors.forename: Sydney
authors.initials: S
authors.lastname: Roberts
authors.forename: Nigel
authors.initials: N
authors.lastname: Spry
authors.forename: Sandra
authors.initials: S
authors.lastname: Turner
authors.forename: Henry
authors.initials: H
authors.lastname: Woo
mesh_terms: D000368:Aged; D001315:Australia; D018572:Disease-Free Survival; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology / Q000532:radiotherapy*; D011183:Postoperative Complications / Q000453:epidemiology / Q000532:radiotherapy*; D011379:Prognosis; D016016:Proportional Hazards Models; D017430:Prostate-Specific Antigen / Q000097:blood; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000532:radiotherapy; D016896:Treatment Outcome
chemical_list: D017430:Prostate-Specific Antigen