Radiation Oncology/Prostate/Recurrence after RT
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Front Page: Radiation Oncology | RTOG Trials | Randomized Trials |
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Prostate: Main Page | Prostate Overview | Screening and Prevention | Workup | Natural History | External Beam RT | IMRT | Androgen Suppression Therapy | Brachytherapy | Protons | Prostatectomy | Adjuvant RT after Prostatectomy | Salvage RT | Chemotherapy | Localized prostate cancer | Node Positive | Advanced disease | Recurrence after RT | Cryotherapy | RTOG Prostate Trials | Randomized Evidence |
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Salvage treatments for biochemical failure after definitive radiotherapy.
[edit] Androgen ablation
Intermittent androgen ablation:
- Canadian trial - phase II
- PMID 16783817, 2006 — "Final results of the Canadian prospective phase II trial of intermittent androgen suppression for men in biochemical recurrence after radiotherapy for locally advanced prostate cancer: clinical parameters." Bruchovsky N et al. Cancer. 2006 Jul 15;107(2):389-95.
- 103 pts. Each cycle consisted of cyproterone acetate (CA) x 4 wks then Lupron plus CA for a total of 36 wks.
- Median f/u 4.2 yrs. Time off treatment averaged 53% of total cycle time.
[edit] Brachytherapy
HDR:
- UCSF (1998-2005)
- PMID 17197119, 2006 — "Feasibility of High-Dose-Rate Brachytherapy Salvage for Local Prostate Cancer Recurrence After Radiotherapy: The University of California-San Francisco Experience." Lee B et al. Int J Radiat Oncol Biol Phys. 2006 Dec 28.
- 21 pts. 36 Gy in 6 fractions.
- Conclusion: "feasible and effective"
[edit] Prostatectomy
Salvage Prostatectomy:
- Memorial Sloan-Kettering
- PMID 12756084, 2003 — "Salvage radical prostatectomy for recurrence of prostate cancer after radiation therapy." Eastham et al. Curr Urol Rep. 2003 June.
- Incontinence rates are similar to incontinence rates after up front prostatectomy
- Note: Most other series report higher incontinence rates in the range of 50%
