Results of three dimensional conformal radiotherapy and hormonal therapy for local recurrence after radical prostatectomy.
OBJECTIVE
Analysis of treatment results of combined three-dimensional conformal radiotherapy (3DCRT) and hormonal therapy in patients with locally recurrent prostate cancer after radical prostatectomy.


METHODS
Between 1992 and 1998, 24 patients presented with a rising prostate-specific antigen (PSA) between 4 and 152 months following radical prostatectomy and a local recurrence demonstrated by imaging. Recurrence was biopsy-proven in 13 cases. All patients were treated with 3DCRT to a total dose of 60-70 Gy. 21 patients (88%) received adjuvant hormone therapy up to a maximum of 6 months.


RESULTS
All patients showed a response in PSA values after therapy. Median follow-up is 43 months. Overall survival is 80% and 67% at 3 and 5 years, respectively. Biochemical control rates are 53% and 38% at 3 and 5 years, respectively. 14 patients developed a second PSA relapse. Acute and late toxicities, classified with the RTOG score, were moderate.


CONCLUSIONS
Radiotherapy and short-term adjuvant hormone therapy represent an effective and well-tolerated treatment for locally recurrent prostate cancer after radical prostatectomy resulting in good local control. Long-term prognosis in terms of biochemical control and disease-specific survival remains poor.
Schwarz
Rudolf
R
Klinik für Strahlentherapie und Radioonkologie, Universitätskrankenhaus Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany. rschwarz@uke.uni-hamburg.de
Krüll
Andreas
A
Tribius
Silke
S
Alberti
Winfried
W
D000230:Adenocarcinoma / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D001706:Biopsy; D005500:Follow-Up Studies; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000532:radiotherapy*; D009367:Neoplasm Staging; D010173:Palpation; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery*; D020266:Radiotherapy, Conformal / Q000379:methods*; D012189:Retrospective Studies; D016019:Survival Analysis; D017741:Survivors; D013997:Time Factors