Salvage Radiotherapy for Patients with PSA Relapse Following Radical Prostatectomy: Issues and Challenges

Overview

Journal Cancer Res Treat

Specialty Oncology

Date 2010 Apr 7

PMID 20369045

Citations 13

Authors

Richard Choo

Affiliations

Soon will be listed here.

Abstract

A progressively rising level of serum prostate specific antigen (PSA) after radical prostatectomy (RP) invariably indicates the recurrence of prostate cancer. The optimal management of patients with post-RP PSA relapse has remained uncertain due to a wide variability in the natural course of post-RP PSA relapse and the inability to separate a recurrent disease confined to the prostate bed from that with occult distant metastasis. Management uncertainty is further compounded by the lack of phase III clinical studies demonstrating which therapeutic approach, if any, would prolong life with no significant morbidity. Radiotherapy has been the main therapeutic modality with a curative potential for patients with post-RP PSA relapse. This review article depicts issues and challenges in the management of patients with post-RP PSA relapse, presents the literature data for the efficacy of salvage radiotherapy, either alone or in combination of androgen ablation therapy, and discusses future directions that can optimize treatment strategies.

Citing Articles

Kurz induces mitochondrial-mediated apoptosis BAX, Bcl-2, and caspase-3 pathways in LNCaP human prostate cancer cell line.

Phongsuwichetsak C, Suksrichavalit T, Chatupheeraphat C, Eiamphungporn W, Yainoy S, Yamkamon V PeerJ. 2024; 12:e17637.

PMID: 38966207 PMC: 11223595. DOI: 10.7717/peerj.17637.

Dose-escalated Salvage Whole-pelvic Radiotherapy for Biochemical Recurrence After Radical Prostatectomy for High-risk Prostate Cancer.

Miyazaki S, Tasaki Y, Nakatake M, Honda K, Nakamura D, Egawa A Cancer Diagn Progn. 2024; 4(3):315-319.

PMID: 38707723 PMC: 11062159. DOI: 10.21873/cdp.10326.

Salvage Radiotherapy Management Decisions in Postprostatectomy Patients with Recurrent Prostate Cancer Based on F-Fluciclovine PET/CT Guidance.

Abiodun-Ojo O, Jani A, Akintayo A, Akin-Akintayo O, Odewole O, Tade F J Nucl Med. 2021; 62(8):1089-1096.

PMID: 33517323 PMC: 8833876. DOI: 10.2967/jnumed.120.256784.

Elective pelvic irradiation in prostate cancer patients with biochemical failure following radical prostatectomy: A propensity score matching analysis.

Song C, Byun S, Kim Y, Ahn H, Byun S, Kim C PLoS One. 2019; 14(4):e0215057.

PMID: 30973905 PMC: 6459518. DOI: 10.1371/journal.pone.0215057.

Clinical impact of PSMA-based F-DCFBC PET/CT imaging in patients with biochemically recurrent prostate cancer after primary local therapy.

Mena E, Lindenberg M, Shih J, Adler S, Harmon S, Bergvall E Eur J Nucl Med Mol Imaging. 2017; 45(1):4-11.

PMID: 28894899 PMC: 7983162. DOI: 10.1007/s00259-017-3818-x.

References

Koppie T, Grossfeld G, Nudell D, Weinberg V, Carroll P . Is anastomotic biopsy necessary before radiotherapy after radical prostatectomy?. J Urol. 2001; 166(1):111-5. View

Moul J, Wu H, Sun L, McLeod D, Amling C, Donahue T . Early versus delayed hormonal therapy for prostate specific antigen only recurrence of prostate cancer after radical prostatectomy. J Urol. 2004; 171(3):1141-7. DOI: 10.1097/01.ju.0000113794.34810.d0. View

Partin A, Oesterling J . The clinical usefulness of prostate specific antigen: update 1994. J Urol. 1994; 152(5 Pt 1):1358-68. DOI: 10.1016/s0022-5347(17)32422-9. View

Nagda S, Mohideen N, Lo S, Khan U, Dillehay G, Wagner R . Long-term follow-up of 111In-capromab pendetide (ProstaScint) scan as pretreatment assessment in patients who undergo salvage radiotherapy for rising prostate-specific antigen after radical prostatectomy for prostate cancer. Int J Radiat Oncol Biol Phys. 2007; 67(3):834-40. DOI: 10.1016/j.ijrobp.2006.09.026. View

Moul J, Connelly R, Lubeck D, Bauer J, Sun L, Flanders S . Predicting risk of prostate specific antigen recurrence after radical prostatectomy with the Center for Prostate Disease Research and Cancer of the Prostate Strategic Urologic Research Endeavor databases. J Urol. 2001; 166(4):1322-7. View

Cookson M, Aus G, Burnett A, Canby-Hagino E, DAmico A, Dmochowski R . Variation in the definition of biochemical recurrence in patients treated for localized prostate cancer: the American Urological Association Prostate Guidelines for Localized Prostate Cancer Update Panel report and recommendations for a standard in.... J Urol. 2007; 177(2):540-5. DOI: 10.1016/j.juro.2006.10.097. View

Shipley W, DeSilvio M, Pilepich M, Roach 3rd M, Wolkov H, Sause W . Early initiation of salvage hormone therapy influences survival in patients who failed initial radiation for locally advanced prostate cancer: A secondary analysis of RTOG protocol 86-10. Int J Radiat Oncol Biol Phys. 2006; 64(4):1162-7. DOI: 10.1016/j.ijrobp.2005.09.039. View

Koontz B, Mouraviev V, Johnson J, Mayes J, Chen S, Wong T . Use of local (111)in-capromab pendetide scan results to predict outcome after salvage radiotherapy for prostate cancer. Int J Radiat Oncol Biol Phys. 2008; 71(2):358-61. DOI: 10.1016/j.ijrobp.2007.10.020. View

Naya Y, Okihara K, Evans R, Babaian R . Efficacy of prostatic fossa biopsy in detecting local recurrence after radical prostatectomy. Urology. 2005; 66(2):350-5. DOI: 10.1016/j.urology.2005.03.014. View

10.

Thompson I, Tangen C, Paradelo J, Lucia M, Miller G, Troyer D . Adjuvant radiotherapy for pathological T3N0M0 prostate cancer significantly reduces risk of metastases and improves survival: long-term followup of a randomized clinical trial. J Urol. 2009; 181(3):956-62. PMC: 3510761. DOI: 10.1016/j.juro.2008.11.032. View

11.

Swanson G, Hussey M, Tangen C, Chin J, Messing E, Canby-Hagino E . Predominant treatment failure in postprostatectomy patients is local: analysis of patterns of treatment failure in SWOG 8794. J Clin Oncol. 2007; 25(16):2225-9. DOI: 10.1200/JCO.2006.09.6495. View

12.

Sciarra A, Panebianco V, Salciccia S, Osimani M, Lisi D, Ciccariello M . Role of dynamic contrast-enhanced magnetic resonance (MR) imaging and proton MR spectroscopic imaging in the detection of local recurrence after radical prostatectomy for prostate cancer. Eur Urol. 2008; 54(3):589-600. DOI: 10.1016/j.eururo.2007.12.034. View

13.

Cooperberg M, Broering J, Kantoff P, Carroll P . Contemporary trends in low risk prostate cancer: risk assessment and treatment. J Urol. 2007; 178(3 Pt 2):S14-9. PMC: 2987559. DOI: 10.1016/j.juro.2007.03.135. View

14.

Stephenson A, Shariat S, Zelefsky M, Kattan M, Butler E, Teh B . Salvage radiotherapy for recurrent prostate cancer after radical prostatectomy. JAMA. 2004; 291(11):1325-32. DOI: 10.1001/jama.291.11.1325. View

15.

Bernard Jr J, Buskirk S, Heckman M, Diehl N, Ko S, Macdonald O . Salvage radiotherapy for rising prostate-specific antigen levels after radical prostatectomy for prostate cancer: dose-response analysis. Int J Radiat Oncol Biol Phys. 2009; 76(3):735-40. DOI: 10.1016/j.ijrobp.2009.02.049. View

16.

Pearse M, Choo R, Danjoux C, Gardner S, Morton G, Szumacher E . Prospective assessment of gastrointestinal and genitourinary toxicity of salvage radiotherapy for patients with prostate-specific antigen relapse or local recurrence after radical prostatectomy. Int J Radiat Oncol Biol Phys. 2008; 72(3):792-8. DOI: 10.1016/j.ijrobp.2008.05.063. View

17.

Raj G, Partin A, Polascik T . Clinical utility of indium 111-capromab pendetide immunoscintigraphy in the detection of early, recurrent prostate carcinoma after radical prostatectomy. Cancer. 2002; 94(4):987-96. View

18.

Jacinto A, Fede A, Fagundes L, Salvajoli J, Castilho M, Viani G . Salvage radiotherapy for biochemical relapse after complete PSA response following radical prostatectomy: outcome and prognostic factors for patients who have never received hormonal therapy. Radiat Oncol. 2007; 2:8. PMC: 1820601. DOI: 10.1186/1748-717X-2-8. View

19.

Symon Z, Kundel Y, Sadetzki S, Oberman B, Ramon J, Laufer M . Radiation rescue for biochemical failure after surgery for prostate cancer: predictive parameters and an assessment of contemporary predictive models. Am J Clin Oncol. 2006; 29(5):446-50. DOI: 10.1097/01.coc.0000221237.58653.0e. View

20.

Choo R, Hruby G, Hong J, Bahk E, Hong E, Danjoux C . (IN)-efficacy of salvage radiotherapy for rising PSA or clinically isolated local recurrence after radical prostatectomy. Int J Radiat Oncol Biol Phys. 2002; 53(2):269-76. DOI: 10.1016/s0360-3016(02)02730-x. View