“Neoadjuvant Hormone Therapy Before Salvage Radiotherapy for an Increasing Post-radical Prostatectomy Serum Prostate Specific Antigen Level”
TIGUERT, RABI; RIGAUD, JEROME; LACOMBE, LOUIS; LAVERDIERE, JACQUES; FRADET, YVES Journal of Urology. 170(2, Part 1):447-450, August 2003.
Within this study doctors retrospectively
evaluated 81 patients who were treated with neoadjuvant
androgen deprivation therapy before salvage external
beam radiation treatment due to an increased PSA
level following radical
retropubic prostatectomy. Patients were analyzed
based on the outcome of preoperative, pathological,
postoperative characteristics, pre-salvage treatment,
and radiation therapy. Prior to the salvage radiotherapy
patients received a 3-month injection of a luteinizing
hormone releasing hormone analogue.
Doctors followed up with their patients approximately
38 months after external beam radiation and 91 months
after radical prostatectomy. At 3 years 75% of patients
were free of biochemical failure and 50% were at 5 years.
Two patients (2%) died of prostate cancer. Those who
benefited most from this treatment were patients with
a pre-radiation PSA level less than 1 and a Gleason
score less than 7.
"Benefit of Adjuvant Radiation Therapy for Localized Prostate Cancer with a Positive Surgical Margin”
LEIBOVICH, BRADLEY C.; ENGEN, DONALD E.; PATTERSON, DAVID E.; PISANSKY, THOMAS M.; ALEXANDER, ERIK E.; BLUTE , MICHAEL L.; BERGSTRALH, ERIK J.; ZINCKE, HORST Journal of Urology. 163(4):1178-1182, April 2000.
The purpose of this study was to
determine the benefit of postoperative external beam
radiation therapy in patients with positive margins.
Included in this retrospective review were 76 patients
with a pathological stage T2 prostate cancer and a single
positive margin who underwent adjuvant radiation therapy
within 3 months of radical
prostatectomy. The positive margin appeared in the
apex of 35 patients, in the prostatic base
of 18, the posterior prostate of 11, the urethra of
7, and the prostatic apex
and urethra of 5. All patients were analyzed against
76 patients who did not receive adjuvant radiation therapy.
After five years 88% of patients treated with adjuvant
radiation experienced clinical and biochemical
progression-free survival, compared
to 59% of patients with no radiation. No one who received
radiation therapy had local or distant recurrence, however
16% of patients without radiation therapy did.
“Prostate Specific Antigen Doubling Time as a Surrogate End Point for Prostate Cancer Specific Mortality Following Radical Prostatectomy or Radiation Therapy”
D'AMICO, ANTHONY V.; MOUL, JUDD; CARROLL, PETER R.; SUN, LEON; LUBECK, DEBORAH; CHEN, MING-HUI Journal of Urology. Innovations and Challenges in Prostate Cancer: Prevention, Detection and Treatment: Fourth International Conference. 172(5, Part 2 of 2) Supplement:S42-S47, November 2004.
In this study information was gathered
on 8,660 patients of which 5,918 were treated with surgery
and 2, 751 were treated with radiation from January
1, 1988 to January 1, 2002. Once a PSA defined recurrence
was compiled, doctors determined that the PSA doubling
time less than 3 months and at 3 months or greater was
associated with prostate cancer specific mortality.
In order to prevent bone
metastasis doctors in this study recommend that
consideration be given to enrollment onto a clinical
trial and/or starting androgen suppression therapy at
the time of PSA defined recurrence when the doubling
time is less than 3 months.