Salvage RT increases survival in recurrent prostate ca

SAN FRANCISCO-Providing radiation therapy for prostate cancer patients who have rising PSA levels after radical prostatectomy reduced the risk of dying from prostate cancer by more than 60% at 10 years, according to a retrospective study of patients treated at Johns Hopkins.

“These findings are the first to support the effectiveness of salvage radiotherapy for improving survival in men with recurrent prostate cancer,” lead author Bruce J. Trock, PhD, of Hopkins’ Brady Urological Institute, said at the 2008 GU Cancers Symposium.

The study included 635 men who had a biochemical recurrence from 1982 to 2004: 160 had received salvage radiotherapy (SRT), 78 SRT plus hormonal therapy, and 397 no salvage therapy.

At 10 years, 86% of the SRT group and 82% of the SRT/hormonal therapy group had not died from prostate cancer vs 62% of those who received no salvage therapy. The results did not change after taking into account individual patient characteristics associated with prognosis.

The study also showed that prostate-cancer-specific survival improved significantly only when SRT was given less than 2 years after biochemical recurrence.

The impact of SRT was particularly strong in men whose PSA levels doubled in less than 6 months, with an 86% reduction in the risk of prostate cancer death with SRT vs no SRT, Dr. Trock said. The results in men with longer PSA doubling times were not significant due to the fact that these men had less aggressive disease and may have fared well even without radiotherapy.