[Salvage radiotherapy for patients with PSA relapse after radical prostatectomy: comparisons among ASTRO and Phoenix biochemical failure definitions].
OBJECTIVE
Study about the efficacy of salvage radiotherapy (RT), in terms of biochemical disease free survival (bDFS), according to ASTRO and Phoenix (nadir+2) definitions, for persistent or rising PSA after radical prostatectomy.


METHODS
Retrospective analysis of 59 patients who underwent RT between 1990 and 2003 for PSA recurrence after radical prostatectomy. Patients received a median of 66Gy to the prostate bed with 3D or 2D RT. The main end point was bDFS according to ASTRO and Phoenix (nadir+2) definitions. Different criterion sets were analysed to calculate bDFS and pretreatment factors that might predict biochemical relapse were sought for each.


RESULTS
After a 38-month median follow-up, the 3-year bDFS rates were: 60 and 72% for ASTRO and Phoenix (nadir+2 ng/ml) definitions respectively. According to univariate analysis, pre-RT PSA> or =1 ng/ml and seminal vesicle involvement were associated with biochemical relapse. Multivariate analysis retained only pre-RT PSA> or =1 ng/ml as an independent predictor of biochemical relapse for the two definitions.


CONCLUSIONS
Salvage RT is an effective treatment after radical prostatectomy according to ASTRO or Phoenix definitions. Only pre-RT PSA> or =1 ng/ml predicted relapse.
Quero
L
L
Service de cancérologie-radiothérapie, hôpital Saint-Louis, AP-HP, 1 avenue Claude-Vellefaux, Paris, France.
Mongiat-Artus
P
P
Ravery
V
V
Hennequin
V
V
Maylin
C
C
Desgrandchamps
F
F
Hennequin
C
C
D018572:Disease-Free Survival; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000097:blood / Q000401:mortality / Q000532:radiotherapy*; D016016:Proportional Hazards Models; D017430:Prostate-Specific Antigen / Q000097:blood*; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000097:blood / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery; D018787:Radiation Oncology / Q000592:standards; D011879:Radiotherapy Dosage; D012016:Reference Values; D012189:Retrospective Studies; D016879:Salvage Therapy / Q000379:methods* / Q000401:mortality; D012955:Societies, Medical / Q000592:standards
D017430:Prostate-Specific Antigen