Some people herein considering 2nd line treatment using radiation for like failed surgery, should have some concept of some of the parameters and knowledge up front before jumping into or signing onto "salvage" radiation. (in this abstract). I think this was 2007:
In the May 20th issue of the Journal of Clinical Oncology, Stephenson and colleagues reported the results of a multi-institutional review attempting to identify which characteristics predict successful treatment with salvage radiotherapy for recurrent prostate cancer after radical prostatectomy. A nomogram was presented to predict the probability of cancer control 6 years after salvage radiotherapy.
A cohort of 1,540 men who received salvage radiotherapy for recurrence after radical prostatectomy was identified from 17 medical centers. PSA recurrence after prostatectomy was defined as a serum PSA of 0.2 ng/ml and rising or a single PSA of 0.5 ng/ml or greater. The variables included in the Cox regression analysis were pre-prostatectomy PSA, Gleason score, extracapsular extension, seminal vesicle invasion, surgical margins, lymph node status, persistently elevated PSA post-RRP, pre-radiotherapy PSA, PSA doubling time, neoadjuvant androgen deprivation and radiation dose.
The probability of remaining free of disease after 6 years was 32% for the entire cohort (95% CI, 28% to 35%), which improved to 48% for patients who received their radiotherapy before their PSA reached 0.6 ng/ml. The most important variables in the model were the serum PSA level before radiotherapy, surgical margin status, use of androgen deprivation before or during radiotherapy and the presence of lymph node metastasis.
This retrospective study with a large cohort of patients treated with salvage radiotherapy after prostatectomy suggests that up to 50% of patients may remain free of disease 6 years after treatment if it is instituted before their serum PSA rises above 0.5 ng/ml. The nomogram proposed predicts with reasonable accuracy which patients are more likely to exhibit a favorable response to salvage radiotherapy and may aid in clinical decision-making,
Stephenson AJ, Scardino PT, Kattan MW, Pisansky TM, Slawin KM, Klein EA, Anscher MS, Michalski JM, Sandler HM, Lin DW, Forman JD, Zelefsky MJ, Kestin LL, Roehrborn CG, Catton CN, DeWeese TL, Liauw SL, Valicenti RK, Kuban DA, Pollack A
Of course always look at other data and other abstracts and anything of possible value when assessing your own case and its parameters, issues, uniqueness etc. Try to verify in effect any claim made on PCa atleast to some degree....never an easy task in this journey.
Post Edited (zufus) : 2/21/2009 4:25:00 PM (GMT-7)