title: Use of Postprostatectomy Radiation Therapy at an NCI-Designated Comprehensive Cancer Center.
abstract: OBJECTIVE
  Characterize use of postprostatectomy radiation (PPRT) for patients with prostate cancer at an NCI-designated comprehensive cancer center.
  
  
  METHODS
  We queried our prospective prostate cancer database for patients treated with 60 to 68 Gy of radiation therapy (RT) to the prostate bed after prostatectomy from 2003 to 2011. Prostatectomy cases were obtained from billing records. Patients with an intact prostate treated with definitive RT served as a control for the change in volume of patients with prostate cancer treated in the department. Chi-square analysis assessed differences between adjuvant and salvage RT cohorts. Spearman correlation assessed yearly trends in prostate-specific antigen (PSA) level at the time of referral for RT. Linear regression models tested trends for number of PPRT cases, prostatectomies, and patients with intact prostate receiving radiation across years.
  
  
  RESULTS
  PPRT was used to treat 475 men at Fox Chase Cancer Center from 2003 to 2011 (83 adjuvant and 392 salvage). Over time, an increased proportion of patients receiving RT to the prostate were treated with PPRT. No increase was seen in the proportion of patients treated with adjuvant RT compared with salvage RT (P=.5). Patients receiving adjuvant RT were younger, had higher pathologic Gleason score, pathologic T stage, and rates of positive margins than those receiving salvage RT. Pre-RT PSA values were inversely correlated with year (P=.005). The number of patients referred for salvage RT with a PSA of 0.5 ng/mL or less increased significantly from 7.9% in 2003 to 26.6% in 2011 (P=.002).
  
  
  CONCLUSIONS
  A larger proportion of patients treated with RT for localized prostate cancer are now receiving PPRT. No increase was seen in the proportion of patients treated with adjuvant RT. Over time, patients with lower PSAs were referred for salvage RT.
authors.affiliation: From the Department of Radiation Oncology, Department of Biostatistics, and Division of Urologic Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania.
authors.forename: Jeffrey M
authors.initials: JM
authors.lastname: Martin
authors.affiliation: From the Department of Radiation Oncology, Department of Biostatistics, and Division of Urologic Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania.
authors.forename: Tianyu
authors.initials: T
authors.lastname: Li
authors.affiliation: From the Department of Radiation Oncology, Department of Biostatistics, and Division of Urologic Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania.
authors.forename: Matthew E
authors.initials: ME
authors.lastname: Johnson
authors.affiliation: From the Department of Radiation Oncology, Department of Biostatistics, and Division of Urologic Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania.
authors.forename: Colin T
authors.initials: CT
authors.lastname: Murphy
authors.affiliation: From the Department of Radiation Oncology, Department of Biostatistics, and Division of Urologic Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania.
authors.forename: Alan G
authors.initials: AG
authors.lastname: Howald
authors.affiliation: From the Department of Radiation Oncology, Department of Biostatistics, and Division of Urologic Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania.
authors.forename: Marc C
authors.initials: MC
authors.lastname: Smaldone
authors.affiliation: From the Department of Radiation Oncology, Department of Biostatistics, and Division of Urologic Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania.
authors.forename: Alexander
authors.initials: A
authors.lastname: Kutikov
authors.affiliation: From the Department of Radiation Oncology, Department of Biostatistics, and Division of Urologic Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania.
authors.forename: David Y T
authors.initials: DY
authors.lastname: Chen
authors.affiliation: From the Department of Radiation Oncology, Department of Biostatistics, and Division of Urologic Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania.
authors.forename: Rosalia
authors.initials: R
authors.lastname: Viterbo
authors.affiliation: From the Department of Radiation Oncology, Department of Biostatistics, and Division of Urologic Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania.
authors.forename: Richard E
authors.initials: RE
authors.lastname: Greenberg
authors.affiliation: From the Department of Radiation Oncology, Department of Biostatistics, and Division of Urologic Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania.
authors.forename: Robert G
authors.initials: RG
authors.lastname: Uzzo
authors.affiliation: From the Department of Radiation Oncology, Department of Biostatistics, and Division of Urologic Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania.
authors.forename: Eric M
authors.initials: EM
authors.lastname: Horwitz
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D011182:Postoperative Care; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D018714:Radiotherapy, Adjuvant; D016879:Salvage Therapy; D016896:Treatment Outcome