ArticleRadiation oncology (London, England)2019
Adjuvant versus early salvage radiotherapy: outcome of patients with prostate cancer treated with postoperative radiotherapy after radical prostatectomy.
Article in Radiation oncology (London, England), 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- The Outcome of Immediate Adjuvant Postoperative External Beam Radiotherapy Versus Observation Alone After Radical Prostatectomy in High-Risk Prostate Cancer: A Meta Analysis.Journal of clinical medicine · 2026Review
- Addressing controversial areas in the management of advanced prostate cancer in Canada Areas of consensus and controversy from the third Canadian consensus forum.Canadian Urological Association journal = Journal de l'Association des urologues du Canada · 2024Article
- A meta-analysis on the use of radiotherapy after prostatectomy: adjuvant versus early salvage radiation.Prostate international · 2022Review
- Postoperative Effect Observation and Clinical Study of Dahuang Zhechong Pills fromComputational intelligence and neuroscience · 2022Article
- Long-term Outcomes of Salvage Radiotherapy Using TomoTherapy With Image-guided Radiotherapy for Postoperative Prostate Cancer Patients.Cancer diagnosis & prognosisArticle
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8 authors.
Funding
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Abstract
backgroundAdjuvant (ART) and salvage radiotherapy (SRT) are two common concepts to enhance biochemical relapse free survival (BCRFS) in patients with prostate cancer (PC). We analyzed differences in outcome between ART and SRT in patients with steep decline of PSA-levels after surgery to compare outcome.
methodsWe evaluated 253 patients treated with postoperative RT with a median age of 66 years (range 42-85 years) treated between 2004 and 2014. Patients with additive radiotherapy due to PSA persistence and patients in the SRT group, who did not achieve a postoperative PSA level <0.1 ng/mL were excluded. Hence, data of 179 patients was evaluated. We used propensity score matching to build homogenous groups. A Cox regression model was used to determine differences between treatment options. Median follow-up was 32.5 months (range 1.4-128.0 months).
resultsEarly SRT at PSA levels <0.3 ng/mL was associated with significant longer BCRFS than late SRT (HR: 0.32, 95%-CI: 0.14-0.75, p = 0.009). Multiple Cox regression showed pre-RT PSA level, tumor stage, and Gleason score as predictive factors for biochemical relapse. In the overall group, patients treated with either ART or early SRT showed no significant difference in BCRFS (HR: 0.17, 95%-CI: 0.02-1.44, p = 0.1). In patients with locally advanced PC (pT3/4) BCRFS was similar in both groups as well (HR: 0.21, 95%-CI:0.02-1.79, p = 0.15).
conclusionFor patients with PSA-triggered follow-up, close observation is essential and early initiation of local treatment at low PSA levels (<0.3 ng/mL) is beneficial. Our data suggest, that SRT administered at early PSA rise might be equieffective to postoperative ART in patients with locally advanced PC. However, the individual treatment decision must be based on any adverse risk factors and the patients' postoperative clinical condition. STUDY REGISTRATION: The present work is approved by the Ethics Commission of the Technical University of Munich (TUM) and is registered with the project number 320/14.
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