PARIS—Salvage radiotherapy (SRT) for recurrent prostate cancer (PCa) should be given at the earliest sign of biochemical failure, researchers reported at the 27th Annual Congress of the European Association of Urology.
The best candidates for SRT are those with positive surgical margins (PSMs) and a PSA nadir of 0.1 ng/mL or less after radical prostatectomy (RP), they concluded.
The study, led by Maria Ervandian, MD, and presented by Michael Borre, MD, both of Aarhus University Hospital in Aarhus, Denmark, included 279 patients who received SRT for recurrent PCa. Subjects had a median age of 66 years at the time of SRT and a median nine months of follow-up from SRT.
At the end of follow-up, 58% of patients were without biochemical relapse after SRT. Multivariate analysis showed that PSMs, a post-RP PSA nadir of 1.0 ng/mL or less, and age of 66 years or younger independently predicted PSA recurrence.
Previously at their institution, oncologists needed histological proof of disease recurrence and higher PSA levels before recommending salvage radiotherapy, Dr. Borre noted. “Today, we are more aggressive, and we do treat as soon as the patients do fail, and the prognosis is far much better,” he said.