Early Salvage Radiation After RP Improves Outcomes in Relapsed Prostate Cancer

[Graham49]

Publish Date February 22, 2022

Renal and Urology news

Natasha Persaud

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Prompt initiation of salvage radiation therapy when PSA is less than 0.5 ng/mL leads to better clinical outcomes among patients with relapsed prostate cancer, according to study findings.

Initiating salvage radiation therapy (RT) early after biochemical recurrence of prostate cancer following radical prostatectomy may prolong the time to metastasis, investigators reported at the ASCO Genitourinary Cancers Symposium 2022.

Among 408 patients with prostate cancer who received salvage RT, 187 (45.8%) received early salvage RT at PSA levels of 0.2 to 0.5 ng/mL. Early-salvage RT was significantly associated with 48% and 42% reduced risks for biochemical recurrence and metastasis, respectively, compared with expectant management, Emerson Lee, a medical student at The Johns Hopkins University School of Medicine in Baltimore, Maryland, reported on behalf of his team. Median radiation dose was 68.4 Gy and did not differ significantly between groups.

Nodal involvement was significantly associated with 2.2-fold worse metastasis-free survival, Lee reported. Seminal vesicle invasion was significantly associated with a 1.8-fold increased risk for biochemical failure. The time from prostatectomy to salvage RT did not affect these outcomes.

Of the cohort, 133 (32.6%) patients received neoadjuvant or concurrent androgen deprivation therapy (ADT).

“Independent of pathologic features and use of ADT, the initiation of salvage radiation therapy early after biochemical relapse (PSA ≤ 0.5 ng/ml) following prostatectomy is associated with increased metastasis-free as well as biochemical relapse-free survival,” Lee and colleagues concluded in their study abstract.

Disclosure: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.

Reference

Lee E, Singh T, Han M, et al. Early initiation of salvage radiotherapy is associated with improved metastasis-free survival in patients with relapsed prostate cancer following prostatectomy. Paper presented at: ASCO Genitourinary Cancers Symposium; February 17-19, 2022. Poster 262.

[petercraig2]

Graham,Yes I had 35 sessions of radiation following RP and PSA did not go to zero.

In retrospect I would investigate SBRT (Cyberknife) radiation therapy as it uses about 5 sessions of very focused and stronger radiation doses.

Everything I have read in clinical literature indicates it has better outcomes with less collateral damage.

In my personal experience I had full bladder control before the radiation therapy and now very poor. Not sure if it was the radiation or Estrogen patch therapy but my PSA has been <.008 which is technical remission according to my Oncologist.

Hope this helps

Good luck