Background To evaluate prognostic factors in salvage radiotherapy (RT) for patients

Background To evaluate prognostic factors in salvage radiotherapy (RT) for patients with pre-RT prostate-specific antigen (PSA) < 1. (hazard ratio: 3.512 [95% CI: 1.535-8.037], p = 0.001). The 4-year bRFS rates for pT1-2 and pT3-4 were 79.2% (95% CI: 66.0-92.3%) and 31.7% (95% CI: 17.0-46.4%), respectively. Conclusions In patients who have received salvage RT after RP with PSA < 1.0 ng/ml, pT stage and preoperative PSA were prognostic factors of bRFS. In particular, pT3-4 had a high risk for biochemical recurrence after salvage RT. Keywords: Prostate cancer, Radiotherapy, Radical Prostatectomy, PSA, Pathological tumor stage Background Radical prostatectomy (RP) is one of the curative treatments for prostate cancer. However, biochemical recurrence after radical prostatectomy occurs in approximately 15% to 40% of patients within 5 years [1,2]. Approximately one third of patients with biochemical recurrence will have distant metastases, and the median actuarial period to development of metastases following prostate-specific antigen (PSA) elevation is 8 years [3]. Many studies have demonstrated that salvage radiotherapy (RT) for biochemical recurrence after RP is effective and enables long-term suppression of PSA elevation [4]. Trock et al. reported that 5- and 10-year prostate cancer-specific survival rates were 88% and 62%, respectively, for patients with no salvage treatment and 96% and 86%, respectively, for patients who received salvage RT alone [5]. Recent studies have suggested that early RT is more effective than delayed RT. Some scholarly studies have demonstrated that pre-RT PSA is really a prognostic element [4,6-14]. Predicated on outcomes of these scholarly research, it appears that pre-RT PSA < 1.0 ng/ml like a cutoff worth is one factor predicting PSA re-failure after salvage RT [4,7,8,12], though based on a consensus -panel report published from the American Society of Therapeutic Radiology and Oncology (ASTRO), early treatment (PSA < 1.5 ng/ml) is more lucrative than later on treatment [15]. Nevertheless, some individuals with pre-RT PSA < 1 even.0 ng/ml who've received salvage RT possess biochemical recurrence. The aim of this research was to judge prognostic elements in salvage RT after RP for individuals with pre-RT PSA < 1.0 ng/ml. Between January 2000 and Dec 2009 Strategies Individuals, 102 individuals received salvage RT for biochemical failing after RP in Tohoku College or university Medical center and seven associated hospitals. Even though American Urological Association (AUA) defines biochemical recurrence pursuing RP as preliminary serum TBC-11251 PSA of TBC-11251 0.2 ng/ml with another confirmatory degree of > 0.2 ng/ml [16], the primary criterion for salvage RT with this research was that PSA after RP was 0.1 ng/ml or even more or that PSA after RP was three consecutive increasing. Individuals with massive regional recurrence which was detectable by CT or MRI or individuals with lymph node or faraway metastasis had been excluded out of this research. Patients who continuing to get hormone therapy for PSA failing after RP but became resistant to the hormone therapy had been also excluded. PSA doubling period PSA doubling period (PSADT) was TBC-11251 TBC-11251 determined using PSA ideals above 0.1 ng/ml after RP before start of salvage RT. PSADT had not been calculated for individuals who didn’t possess PSA above 0.1 ng/ml. PSADT was approximated from the organic log of 2 (0.693) divided from the slope from the linear regression type of PSA as time passes [3]. Radiotherapy The prostate bed, the bladder throat, Rabbit Polyclonal to ZNF446 the urethral anastomosis as well as the seminal vesicle bed (in the case of invasion to seminal vesicle) were defined as the clinical target volume (CTV) with references to preoperative computed tomography or magnetic resonance imaging. The planning target volume (PTV) included the CTV with a margin of approximately 1 cm in all directions. The leaf margin was 0.5 cm in all directions. Salvage RT was delivered using photon beams of 10 MV or 15 MV mostly with the four-field technique, three-dimensional conformal RT. The median RT dose was 64.

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