IMRT Shows Promise for PCa Salvage

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ORLANDO—Intensity-modulated radiation therapy (IMRT) may offer a promising salvage option for prostate cancer patients who experience PSA relapse following radical prostatectomy, researchers said.

Jill Rossinow, MD, and her colleagues at Montefiore Medical Center in New York City used IMRT for salvage therapy in 50 men who had rising PSA following radical prostatectomy. The researchers defined the planning target volume as the pros-tate bed plus a 1 cm margin, except 0.7 cm posteriorly.

A median dose of 66.6 Gy was given in 1.8 Gy daily fractions. No more than 20% of the rectum and no more than 25% of the bladder were to receive 65 Gy, and no more than 10% of the small bowel was to receive 45 Gy.

After a median follow-up of 13.6 months, 22 men (44%) had a complete response (a PSA level of 0.04 ng/mL or less) and 24 patients (48%) had a partial response (PSA level of 0.05-0.83 ng/mL). Overall and prostate-cancer specific survival was 96% and 92%, respectively. No grade 3 or 4 toxicities were reported.

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