title: Late toxicity after postprostatectomy salvage radiation therapy.
abstract: OBJECTIVE
  To evaluate late toxicity in patients who received salvage external beam radiotherapy (EBRT) for a detectable prostate-specific antigen (PSA) level after radical prostatectomy (RP).
  
  
  METHODS
  A cohort of 308 consecutive patients underwent salvage EBRT from July 1987 through June 2003 for a detectable PSA level after RP. All were treated with high-energy photons (6-20 MV) to a median dose of 64.8 Gy (range: 54.0-72.4 Gy) in 1.8- to 2.0-Gy fractions.
  
  
  RESULTS
  Median follow-up from the completion of EBRT was 60 months (range: 1 day-174 months). Late toxicity occurring more than 90 days after EBRT completion was identified in 41 patients (13%). Twelve patients (3.9%) had grade 2 urethral strictures and were treated with urethral dilation, 3 patients had grade 3 cystitis, and 1 had a grade 4 rectal complication. These numbers correspond to an estimated 0.7% (95% confidence interval, 0.0-1.6%) of patients experiencing a grade 3 or 4 complication by 5 years after the start of EBRT.
  
  
  CONCLUSIONS
  Salvage EBRT for a detectable PSA level after RP is the only curative treatment in this setting. This treatment can be administered in a manner that results in a low likelihood of late complications.
authors.affiliation: Department of Radiation Oncology, Mayo Clinic, Jacksonville, FL 32224, USA.
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Peterson
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Buskirk
authors.forename: Michael G
authors.initials: MG
authors.lastname: Heckman
authors.forename: Julia E
authors.initials: JE
authors.lastname: Crook
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Ko
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Wehle
authors.forename: Todd C
authors.initials: TC
authors.lastname: Igel
authors.forename: Karin A
authors.initials: KA
authors.lastname: Prussak
authors.forename: Thomas M
authors.initials: TM
authors.lastname: Pisansky
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D017430:Prostate-Specific Antigen / Q000097:blood; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000532:radiotherapy* / Q000601:surgery; D011878:Radiotherapy / Q000009:adverse effects; D011879:Radiotherapy Dosage; D012189:Retrospective Studies; D016879:Salvage Therapy
chemical_list: D017430:Prostate-Specific Antigen