title: Current status and outcomes of patients developing PSA recurrence after prostatectomy who were treated with salvage radiotherapy: a JROSG surveillance study.
abstract: The conditions and outcomes of Japanese patients with prostate cancer who developed PSA failure after radical prostatectomy (RP), and who were treated via salvage radiotherapy (S-RT), were surveyed. Clinical data on S-RT were gathered in questionnaires completed by facilities participating in the Japanese Radiation Oncology Study Group. S-RT was defined as external-beam radiotherapy delivered to the prostate beds of patients with prostate cancer who had eventually developed PSA failure, although their PSA values had at one stage attained levels <0.2 ng/ml following RP. Hormonal therapy was combined with S-RT in ∼40% of cases. Outcomes were evaluated in 186 cases treated via S-RT alone. The nadir PSA level after RP, and the level upon initiation of S-RT, were 0.0135 ng/ml and 0.292 ng/ml, respectively. The median period between RP and S-RT was 18.6 months. The median follow-up period was 58 months. The 5-year PSA recurrence-free survival (PRFS) and clinical failure-free survival (CFFS) rates were 50.1% (95% CI: 42.8-57.9%) and 90.1% (95% CI: 86.4-95.7%), respectively. PRFS was significantly superior in patients with PSA values ≤0.3 ng/ml upon initiation of S-RT than in those with PSA values >0.3 ng/ml (57.5% vs 40.5%, P = 0.027). In Japan, hormonal therapy is combined with S-RT in ∼40% of cases. The 5-year PRFS and CFFS rates of cases treated via S-RT alone were 50.1% and 90.1%, respectively. A PSA value of 0.3 ng/ml served as a significant cut-off for prediction of PRFS.
authors.affiliation: Department of Radiation Oncology and Image-applied Therapy, Graduate School of Medicine, Kyoto University. 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan mizo@kuhp.kyoto-u.ac.jp.
authors.forename: Takashi
authors.initials: T
authors.lastname: Mizowaki
authors.affiliation: Department of Radiology, The Jikei University School of Medicine, 3-25-8 Nishishinbashi, Minato-ku, Tokyo, 105-8461, Japan.
authors.forename: Manabu
authors.initials: M
authors.lastname: Aoki
authors.affiliation: Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Umade, Higashi-ku, Fukuoka, 812-8582, Japan.
authors.forename: Katsumasa
authors.initials: K
authors.lastname: Nakamura
authors.affiliation: Department of Radiology, National Tokyo Medical Center, 2-5-1 Higashigaoka, Meguro-ku, Tokyo, 152-8902, Japan.
authors.forename: Atsunori
authors.initials: A
authors.lastname: Yorozu
authors.affiliation: Department of Radiation Oncology, Kobe City Medical Center General Hospital, 2-1-1 Minatojimaminamimachi, Chuo-ku, Kobe, 650-0047, Japan.
authors.forename: Masaki
authors.initials: M
authors.lastname: Kokubo
authors.affiliation: Department of Radiology, Tokyo Metropolitan Cancer and Infectious diseases Center, Komagome Hospital, 3-18-22 Honkomagome, Bunkyo-ku, Tokyo, 113-8677, Japan.
authors.forename: Katsuyuki
authors.initials: K
authors.lastname: Karasawa
authors.affiliation: Department of Radiation Oncology, Cancer Institute Hospital, 3-8-31 Ariake, Kouto-ku, Tokyo, 135-8550, Japan.
authors.forename: Takuyo
authors.initials: T
authors.lastname: Kozuka
authors.affiliation: Department of Radiology, Shizuoka General Hospital, 4-27-1 Kitaando, Aoi-ku, Shizuoka, 420-8527, Japan.
authors.forename: Nobuaki
authors.initials: N
authors.lastname: Nakajima
authors.affiliation: Department of Radiology, Juntendo University School of Medicine, 3-1-3 Hongo, Bunkyo-ku, Tokyo, 113-8431, Japan.
authors.forename: Keisuke
authors.initials: K
authors.lastname: Sasai
authors.affiliation: Department of Radiation Oncology and Particle Therapy, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa City, Chiba, 277-8577, Japan.
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Akimoto
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000097:blood; D018572:Disease-Free Survival; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000517:prevention & control*; D011184:Postoperative Period; D017430:Prostate-Specific Antigen / Q000097:blood; D011468:Prostatectomy / Q000401:mortality*; D011471:Prostatic Neoplasms / Q000097:blood / Q000401:mortality* / Q000628:therapy*; D018714:Radiotherapy, Adjuvant / Q000401:mortality*; D020266:Radiotherapy, Conformal / Q000401:mortality; D012189:Retrospective Studies; D016879:Salvage Therapy / Q000401:mortality*; D018571:Sentinel Surveillance; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D014408:Biomarkers, Tumor; D017430:Prostate-Specific Antigen
keywords: PSA recurrence; prostate cancer; radical prostatectomy; salvage radiotherapy