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Galileo
Veteran Member


Date Joined Nov 2008
Total Posts : 697
   Posted 4/29/2011 5:15 PM (GMT -6)   
A small study from a single institution confirms what Drs. Catalona and Stephenson found independently, in larger studies before--that although most men see their PSA fall after salvage radiation, in the long run, the majority will see it come back.

"Men with postoperative PSA relapse can undergo salvage treatment by prostate bed radiotherapy, but durable PSA control is maintained only in about one-third of the patients. Despite a high biochemical failure rate after SRT, prostate cancer-specific survival does not decrease rapidly."
www.ncbi.nlm.nih.gov/pubmed/21514736
Galileo

Dx Feb 2006, PSA 9 @age 43
RRP Apr 2006 - Gleason 3+4, T2c, NX MX, pos margins
PSA 5/06 <0.1, 8/06 0.2, 12/06 0.6, 1/07 0.7.
Salvage radiation (IMRT) Jan-Mar 2007
PSA 9/2007 and thereafter <0.1
pcabefore50.blogspot.com

reachout
Veteran Member


Date Joined May 2009
Total Posts : 725
   Posted 4/29/2011 5:28 PM (GMT -6)   
I was confused by the double negative structure of the last sentence:

"Despite a high biochemical failure rate after SRT, prostate cancer-specific survival does not decrease rapidly."

So that's saying that, even though SRT often fails to keep PCA low, that doesn't translate to an increase rate of dying from PC. Is my reading correct?
Age: 66
PSA: 7 tests over 2 years bounced around from 2.6 to 5.6
Biopsy 8 of 12 positive, Gleason 3+4, T2a
DaVinci August 2009, pathology Gleason 4+3, neg margins, T2c
Continent right away, ED
Viagra, Cialis did't work, Trimix works well
Post-surgery PSA:
3, month: undetectable <.1; 6 month: undetectable <.014 (ultrasensitive); 9, 12, 15 month: undetectable <.1; 18 month detectable .05

Galileo
Veteran Member


Date Joined Nov 2008
Total Posts : 697
   Posted 4/29/2011 5:42 PM (GMT -6)   
Right.
They're saying exactly that. The biochemical failure rate is high, but survival was still up there pretty high.

I wouldn't read *too* much into this small study with a short followup. I just mention it because I follow SRT obsessively :)

Here's Catalona's older study on this, with a followup of 10 years:
www.ncbi.nlm.nih.gov/pubmed/16145393?dopt=Abstract
Galileo

Dx Feb 2006, PSA 9 @age 43
RRP Apr 2006 - Gleason 3+4, T2c, NX MX, pos margins
PSA 5/06 <0.1, 8/06 0.2, 12/06 0.6, 1/07 0.7.
Salvage radiation (IMRT) Jan-Mar 2007
PSA 9/2007 and thereafter <0.1
pcabefore50.blogspot.com

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 4/29/2011 5:51 PM (GMT -6)   
Interesting read, pretty well in line with what I was told before starting and failing SRT. It's hard to take any study seriously thats only based on 96 men, and I noticed the average dosing was 64.8 gys, which in our day and age of IMRT, etc, averages out to a much lower dose than normally administered.

David in SC
Age: 58, 56 dx, PSA: 7/07 5.8, 10/08 16.3
3rd Biopsy: 9/08 7 of 7 Positive, 40-90%, Gleason 4+3
open RP: 11/08, on catheters for 101 days
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos margin
Incont & ED: None
Post Surgery PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, 8/6 .06, 2/11 1.24, 4/11 3.81
Latest: 6 Corr Surgeries to Bladder Neck, SP Catheter since 10/1/9, SRT 39 Sess/72 gy ended 11/09, 21 Catheters, Ileal Conduit Surgery 9/10

compiler
Veteran Member


Date Joined Nov 2009
Total Posts : 7204
   Posted 4/29/2011 11:29 PM (GMT -6)   
Actually, this fits the predictions from the MSK nomographs.
 
Mel
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