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Outcomes and Prediction Models for Exclusive Prostate Bed Salvage Radiotherapy among Patients with Biochemical Recurrence after Radical Prostatectomy
- Source :
- Cancers, Vol 13, Iss 2672, p 2672 (2021), Cancers, Volume 13, Issue 11
- Publication Year :
- 2021
- Publisher :
- MDPI AG, 2021.
-
Abstract
- Background: The addition of androgen-deprivation therapy (ADT) or pelvic radiation to prostate bed salvage radiotherapy (SRT) has been debated for prostate cancer patients with biochemical recurrence (BCR) after radical prostatectomy. This study aimed to assess the outcomes and propose prediction models for exclusive prostate bed SRT. Methods: This is a prospective observational cohort study with patients who underwent SRT with a pre-SRT PSA &lt<br />1.5 ng/mL after radical prostatectomy. Patients were treated with 70-Gy SRT to the prostate bed exclusively. Kaplan–Meier survival analyses and Cox regression analyses were applied for depicting and predicting BCR-free survival, ADT-free survival, and metastasis-free survival (MFS). Regression-based coefficients were used to develop nomograms. Results: A total of 105 patients were included and 91 patients were eligible. The median follow-up period was 39 months. The 5-year BCR-free survival, ADT-free survival, and MFS were 37%, 50%, and 66%, respectively. Multivariable analysis showed that a pre-SRT PSA &lt<br />0.45 ng/mL was the only independent factor associated with longer BCR-free survival (p = 0.034), while a PSA-DT &gt<br />8 months had better ADT-free survival (p = 0.008). Patients with a PSA-DT &gt<br />8 months showed a 100% MFS and a 43% 5-year absolute benefit in MFS than a PSA-DT ≤ 8 months. All patients with a pre-SRT PSA &lt<br />0.45 ng/mL and PSA-DT &gt<br />8 months were free from subsequent ADT and any metastasis. Conclusions: In patients with a PSA &lt<br />8 months for post-prostatectomy BCR, prostate bed SRT provided excellent outcomes without the need for concomitant ADT or pelvic radiotherapy.
- Subjects :
- Biochemical recurrence
Cancer Research
medicine.medical_specialty
medicine.medical_treatment
030232 urology & nephrology
Urology
urologic and male genital diseases
Article
Metastasis
Androgen deprivation therapy
03 medical and health sciences
Prostate cancer
0302 clinical medicine
salvage
medicine
metastasis
radiotherapy
RC254-282
Prostatectomy
business.industry
Neoplasms. Tumors. Oncology. Including cancer and carcinogens
prostate cancer
medicine.disease
Radiation therapy
Oncology
Prostate Bed
030220 oncology & carcinogenesis
Concomitant
androgen-deprivation therapy
business
human activities
Subjects
Details
- ISSN :
- 20726694
- Volume :
- 13
- Database :
- OpenAIRE
- Journal :
- Cancers
- Accession number :
- edsair.doi.dedup.....4e6ae33989ed195d7213ac98a59b715a