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Clinical and Translational Oncology

, Volume 21, Issue 3, pp 355–362 | Cite as

Postoperative adjuvant and very early salvage radiotherapy after prostatectomy in high-risk prostate cancer patients can improve specific and overall survival

  • F. CasasEmail author
  • I. Valduvieco
  • G. Oses
  • L. Izquierdo
  • I. Archila
  • M. Costa
  • K. S. Cortes
  • T. Barreto
  • F. Ferrer
Research Article
  • 129 Downloads

Abstract

Purpose

Adjuvant radiotherapy (ART) for biochemical relapse (BR) after radical prostatectomy (RP) showed increased disease-free survival (DFS) in three previous randomized trials. Retrospective phase II trials evaluated if early salvage RT (ESRT) is equivalent to ART. Our study aims to compare ART and ESRT to salvage RT.

Materials and methods

We compared RP plus ART and ESRT versus SRT. Indication for RT was made by PSA determination after RP: ART when PSA ≤ 0.2 ng/ml, ESRT when PSA ≤ 0.3 after PSA rise from 0.0 to SRT PSA ≥ 0.3. The cause of death of each patients was analyzed, DFS, cause-specific survival (CSS) overall survival (OS) and metastasis-free survival (MFS) in relation to RT intention.

Results

Between 1993 and 2008, 204 patients with a median age of 65 years (44–75) were treated. The median follow-up was 160 months (28.1–273.3). At diagnosis, 89.7% had localized clinical stages and 90.2% had Gleason (G) ≤ 7. The median PSA was 10 (range 4–101). The postoperative G was ≥ 7 in 66.2%; 56.4% had ≥ 2 positive margins; 29.4% received ART, 20% ESRT and 59.3% SRT. The DFS for ART, ESRT and SRT was 74, 56 and 39% with significant differences between the three groups (p < 0.001). ART + ESRT were combined versus SRT; for the DFS, the significant differences (p < 0.001) remained 67% versus 39%. Positive margins, pT3 and pre-RT PSA were significant factors on multivariate analysis. The CSS in the ART + ESRT group was 92 vs. 78% in the SRT group (p < 0.05). OS was 69% in ART + ESRT vs. 57% in SRT (p < 0.05). MFS was 82.7% in ART + ESRT vs. 67.4% in SRT.

Conclusions

In this study the ART + ESRT presented benefits versus SRT in DFS, CSS, OS and MFS.

Keywords

Postoperative radiotherapy Biochemical relapse Adjuvant radiotherapy Early salvage and salvage radiotherapy 

Notes

Acknowledgements

To Donna Pringle for her English revision of this manuscript.

Compliance with ethical standards

Conflicts of interest

All the authors not have any conflicts of interest.

Ethical approval

Research involving Human Participants and/or Animals it is not performed.

Informed consent

All the patients signed informed consent before postoperative radiotherapy.

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Copyright information

© Federación de Sociedades Españolas de Oncología (FESEO) 2018

Authors and Affiliations

  1. 1.Radiation Oncology DepartmentHospital ClínicBarcelonaSpain
  2. 2.Urology DepartmentHospital ClínicBarcelonaSpain
  3. 3.Pathology DepartmentHospital ClínicBarcelonaSpain
  4. 4.Radiation Oncology Department, Institut Català d’Oncologia, IDIBELLUniversitat de BarcelonaBarcelonaSpain
  5. 5.Departament de Ciències ClíniquesUniversitat de BarcelonaBarcelonaSpain

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