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“Neoadjuvant Hormone Therapy Before Salvage Radiotherapy for an Increasing Post-radical Prostatectomy Serum Prostate Specific Antigen Level”
TIGUERT, RABI; RIGAUD, JEROME; LACOMBE, LOUIS; LAVERDIERE, JACQUES; FRADET, YVES Journal of Urology. 170(2, Part 1):447-450, August 2003.
Within this study doctors retrospectively evaluated 81 patients who were treated with neoadjuvant androgen deprivation therapy before salvage external beam radiation treatment due to an increased PSA level following radical retropubic prostatectomy. Patients were analyzed based on the outcome of preoperative, pathological, postoperative characteristics, pre-salvage treatment, and radiation therapy. Prior to the salvage radiotherapy patients received a 3-month injection of a luteinizing hormone releasing hormone analogue. Doctors followed up with their patients approximately 38 months after external beam radiation and 91 months after radical prostatectomy. At 3 years 75% of patients were free of biochemical failure and 50% were at 5 years. Two patients (2%) died of prostate cancer. Those who benefited most from this treatment were patients with a pre-radiation PSA level less than 1 and a Gleason score less than 7.
"Benefit of Adjuvant Radiation Therapy for Localized Prostate Cancer with a Positive Surgical Margin”
LEIBOVICH, BRADLEY C.; ENGEN, DONALD E.; PATTERSON, DAVID E.; PISANSKY, THOMAS M.; ALEXANDER, ERIK E.; BLUTE , MICHAEL L.; BERGSTRALH, ERIK J.; ZINCKE, HORST Journal of Urology. 163(4):1178-1182, April 2000.
The purpose of this study was to determine the benefit of postoperative external beam radiation therapy in patients with positive margins. Included in this retrospective review were 76 patients with a pathological stage T2 prostate cancer and a single positive margin who underwent adjuvant radiation therapy within 3 months of radical prostatectomy. The positive margin appeared in the apex of 35 patients, in the prostatic base of 18, the posterior prostate of 11, the urethra of 7, and the prostatic apex and urethra of 5. All patients were analyzed against 76 patients who did not receive adjuvant radiation therapy. After five years 88% of patients treated with adjuvant radiation experienced clinical and biochemical progression-free survival, compared to 59% of patients with no radiation. No one who received radiation therapy had local or distant recurrence, however 16% of patients without radiation therapy did.
“Prostate Specific Antigen Doubling Time as a Surrogate End Point for Prostate Cancer Specific Mortality Following Radical Prostatectomy or Radiation Therapy”
D'AMICO, ANTHONY V.; MOUL, JUDD; CARROLL, PETER R.; SUN, LEON; LUBECK, DEBORAH; CHEN, MING-HUI Journal of Urology. Innovations and Challenges in Prostate Cancer: Prevention, Detection and Treatment: Fourth International Conference. 172(5, Part 2 of 2) Supplement:S42-S47, November 2004.
In this study information was gathered on 8,660 patients of which 5,918 were treated with surgery and 2, 751 were treated with radiation from January 1, 1988 to January 1, 2002. Once a PSA defined recurrence was compiled, doctors determined that the PSA doubling time less than 3 months and at 3 months or greater was associated with prostate cancer specific mortality. In order to prevent metastatic bone disease doctors in this study recommend that consideration be given to enrollment onto a clinical trial and/or starting androgen suppression therapy at the time of PSA defined recurrence when the doubling time is less than 3 months.
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