title: Salvage radiotherapy for palpable, locally recurrent prostate cancer after radical prostatectomy.
abstract: OBJECTIVE
  A retrospective study to evaluate the outcome of salvage radiotherapy (RT) for clinically apparent, palpable prostate cancer recurrence after radical prostatectomy (RP).
  
  
  METHODS
  Forty-two patients underwent RT for clinically apparent recurrent prostate cancer after RP between 1993 and 1999. The end points and treatment variables of biochemical disease-free survival were evaluated statistically.
  
  
  RESULTS
  The median follow-up was 4.3 years. All 42 patients experienced resolution of clinically detectable recurrence within 1 year after RT. The 5-year biochemical disease-free survival, local control, freedom from distant metastases, and overall survival rate was 27%, 94%, 82%, and 78%, respectively. The initial pathologic stage (T3 or T4; p = 0.04) and interval (<2 years from RP to RT; p = 0.01) were independent predictors of biochemical failure, and RT simulation without contrast (p = 0.05) was nearly significant on multivariate analysis. Three patients (7%) experienced chronic Grade 3 or 4 RT-related toxicity.
  
  
  CONCLUSIONS
  Salvage prostate bed RT for clinically apparent locally recurrent prostate cancer after RP provides effective local tumor control with modest durable biochemical control. Patients irradiated with a better simulation technique were found to have a more favorable outcome. A consensus on a definition of biochemical disease-free survival after salvage RT is critical for meaningful comparison of the available data and to future progress in treating this disease process.
authors.affiliation: Department of Radiation Oncology, Mayo Clinic, Scottsdale, AZ 85259, USA.
authors.forename: O Kenneth
authors.initials: OK
authors.lastname: Macdonald
authors.forename: Steven E
authors.initials: SE
authors.lastname: Schild
authors.forename: Sujay A
authors.initials: SA
authors.lastname: Vora
authors.forename: Paul E
authors.initials: PE
authors.lastname: Andrews
authors.forename: Robert G
authors.initials: RG
authors.lastname: Ferrigni
authors.forename: Donald E
authors.initials: DE
authors.lastname: Novicki
authors.forename: Scott K
authors.initials: SK
authors.lastname: Swanson
authors.forename: William W
authors.initials: WW
authors.lastname: Wong
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local / Q000097:blood / Q000532:radiotherapy*; D017430:Prostate-Specific Antigen / Q000097:blood; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000097:blood / Q000532:radiotherapy* / Q000601:surgery; D012189:Retrospective Studies; D016879:Salvage Therapy
chemical_list: D017430:Prostate-Specific Antigen