search button

Early salvage radiation therapy combined with short-term hormonal therapy in recurrent prostate cancer after radical prostatectomy: Single-institution 4-year data on outcome, toxicity, health-related quality of life and co-morbidities from 184 consecutive patients treated with 70 Gy

  • Authors:
    • Jeff R. Cortés-González
    • Enrique Castellanos
    • Katinka Sandberg
    • Marie-Hjelm Eriksson
    • Peter Wiklund
    • Stefan Carlsson
    • Gabriella Cohn-Cedermark
    • Ulrika Harmenberg
    • Ove Gustafsson
    • Seymour H. Levitt
    • Bo Lennernäs
    • Yvonne Brandberg
    • Marcela Márquez
    • Karl-Mikael Kälkner
    • Sten Nilsson

  • View Affiliations

  • Published online on: November 13, 2012     https://doi.org/10.3892/ijo.2012.1694
  • Pages: 109-117
Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )
Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )


Abstract

The aim of this study was to investigate the role of 70 Gy salvage radiotherapy (SRT) combined with short-term neoadjuvant hormonal therapy (NHT) in the treatment of recurrent disease after radical prostatectomy (RP), and to consider quality of life (QoL), survival outcomes and impact of co-morbidities on treatment-related rectal-genitourinary toxicity. Electronic records of 184 SRT patients treated consecutively between October 2001 and February 2007 were analyzed. Median age was 64 years (median follow-up 48 months). NHT was given to 165 patients (median 3 months). Pre-RP and pre-SRT PSA, PSA doubling time, Gleason score (GS), seminal vesicle invasion (SVI) and detectable post-SRT PSA were recorded. Any detectable PSA or PSA >0.1 ng/ml + nadir was considered biochemical failure (BcF). The Charlson co-morbidity index was used to correlate co-morbidities and rectal-genitourinary toxicity. Scores from the health-related QoL EORTC QLQ-C30 and PR-25 questionnaires were also evaluated. In 116 (63%) patients, a long-lasting curative effect was indicated by undetectable PSA levels. In univariate analysis, using BcF as an outcome variable, p<0.001 was found for GS, pre-SRT PSA, SVI and detectable post-SRT PSA. Multivariate analysis showed p=0.01 for SVI, p=0.09 for GS, and detectable post-SRT PSA (p=0.01); with metastases as an outcome variable, only SVI was significant (p=0.007). Cancer-specific and overall survival were 99 and 95%, respectively. Although microscopy showed SVI or GS 8-10 in the prostatectomy specimens 17/40 (43%) and 13/29 (45%), respectively, of patients still showed undetectable PSA at long-term follow-up (median 55 months) after SRT. Likewise, 11/31 (36%) patients with pre-SRT PSA >1.0 ng/ml and 80/134 (60%) patients with PSA doubling time (PSADT) <10 still showed undetectable PSA after 50 months. Slightly elevated acute and late rectal-genitourinary grade 3-4 toxicity was observed. No association with co-morbidity/toxicity was found. EORTC QLQ-C30 scores were similar to or slightly better than reference values. SRT with 70 Gy combined with 3-month NHT results in long-term undetectable PSA in >50% of patients with recurrence after RP with acceptable rectal-genitourinary toxicity and without negatively affecting long-term QoL. Non-metastatic patients should not be disqualified from receiving SRT although presenting with poor prognostic factors at surgery.
View Figures
View References

Related Articles

Journal Cover

January 2013
Volume 42 Issue 1

Print ISSN: 1019-6439
Online ISSN:1791-2423

Sign up for eToc alerts

Recommend to Library

  • Journal Metrics
  • Impact Factor: 5.2
  • Ranked Oncology
    (total number of cites)
  • CiteScore: 11.4
  • CiteScore Rank: Q1: #40/366 Oncology
  • Source Normalized Impact per Paper (SNIP): 1.125
  • SCImago Journal Rank (SJR): 1.105
International Symposium on Molecular Medicine Conference Banner
The Cancer Story
World Congress on Advances in Oncology and International Symposium on Molecular Medicine Conference Banner
World Academy Of Sciences Banner
Heyday Road Banner

0

Copy and paste a formatted citation
x
Spandidos Publications style
Cortés-González JR, Castellanos E, Sandberg K, Eriksson M, Wiklund P, Carlsson S, Cohn-Cedermark G, Harmenberg U, Gustafsson O, Levitt SH, Levitt SH, et al: Early salvage radiation therapy combined with short-term hormonal therapy in recurrent prostate cancer after radical prostatectomy: Single-institution 4-year data on outcome, toxicity, health-related quality of life and co-morbidities from 184 consecutive patients treated with 70 Gy. Int J Oncol 42: 109-117, 2013
APA
Cortés-González, J.R., Castellanos, E., Sandberg, K., Eriksson, M., Wiklund, P., Carlsson, S. ... Nilsson, S. (2013). Early salvage radiation therapy combined with short-term hormonal therapy in recurrent prostate cancer after radical prostatectomy: Single-institution 4-year data on outcome, toxicity, health-related quality of life and co-morbidities from 184 consecutive patients treated with 70 Gy. International Journal of Oncology, 42, 109-117. https://doi.org/10.3892/ijo.2012.1694
MLA
Cortés-González, J. R., Castellanos, E., Sandberg, K., Eriksson, M., Wiklund, P., Carlsson, S., Cohn-Cedermark, G., Harmenberg, U., Gustafsson, O., Levitt, S. H., Lennernäs, B., Brandberg, Y., Márquez, M., Kälkner, K., Nilsson, S."Early salvage radiation therapy combined with short-term hormonal therapy in recurrent prostate cancer after radical prostatectomy: Single-institution 4-year data on outcome, toxicity, health-related quality of life and co-morbidities from 184 consecutive patients treated with 70 Gy". International Journal of Oncology 42.1 (2013): 109-117.
Chicago
Cortés-González, J. R., Castellanos, E., Sandberg, K., Eriksson, M., Wiklund, P., Carlsson, S., Cohn-Cedermark, G., Harmenberg, U., Gustafsson, O., Levitt, S. H., Lennernäs, B., Brandberg, Y., Márquez, M., Kälkner, K., Nilsson, S."Early salvage radiation therapy combined with short-term hormonal therapy in recurrent prostate cancer after radical prostatectomy: Single-institution 4-year data on outcome, toxicity, health-related quality of life and co-morbidities from 184 consecutive patients treated with 70 Gy". International Journal of Oncology 42, no. 1 (2013): 109-117. https://doi.org/10.3892/ijo.2012.1694