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    Home > Active Ingredient News > Antitumor Therapy > Prostate: What is the effect of initiating salvage radiotherapy at PSA≤0.5ng/ml on metastasis-free survival in patients with postoperative recurrent prostate cancer?

    Prostate: What is the effect of initiating salvage radiotherapy at PSA≤0.5ng/ml on metastasis-free survival in patients with postoperative recurrent prostate cancer?

    • Last Update: 2022-11-14
    • Source: Internet
    • Author: User
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    Over the past few decades, the mortality rate from prostate cancer has declined
    due to the popularity of early identification of PSA screening and advances in medical and surgical management.
    However, some male patients experience initial biochemical remission after surgery, but eventually biochemical failure and may continue to develop metastatic disease
    .
    Salvage radiation therapy (SRT) is indicated for biochemical failure
    following radical prostatectomy.
    Previous data suggest that initiating SRT therapy at lower PSA levels improves subsequent biochemical control, although the optimal timing of SRT treatment remains in question
    given the long natural history of prostate cancer.

    Recently, researchers from the United States published an article in Prostate investigating the effect of prostate-specific antigen (PSA) levels during salvage radiotherapy on relapse-free survival (bRFS) and metastasis-free survival (MFS) in patients with biochemical relapse.

    Using prospective institutional tumor registry data, the researchers constructed univariate and multivariate-adjusted Cox proportional risk models to assess the association between treatment outcomes and clinical and pathologic prognostic features, including pre-SRT PSA, interval from prostatectomy to SRT, androgen deprivation therapy (ADT), and adverse pathologic features
    .

    The study included 397 patients
    who received salvage RT between 1985 and 2016.
    In 187 (45.
    8%) patients, PSA ≤ 0.
    5 ng/ml before initiating SRT therapy; In 212 (52.
    0%) patients, PSA > 0.
    5 ng/ml
    before initiating SRT.
    Independent of pathologic risk status and ADT use, pre-SRT PSAs ≤ 0.
    5 ng/ml were the most important predictors of
    bRFS (HR = 0.
    39, 95% CI [0.
    27 to 0.
    56]) and MFS (HR = 0.
    58, 95% CI [0.
    37 to 0.
    91]).
    Seminal vesicle invasion is also associated
    with shorter intervals of biochemical defeat (HR = 1.
    79, 95% CI [1.
    07 to 2.
    98]) and final metastasis (HR = 2.
    07, 95% CI [1.
    14 to 3.
    740]).

    Biochemical relapse-free survival in different subgroups

    In summary, initiation of salvage RT at PSA levels of ≤ 0.
    5 ng/ml was associated with

    MFS improvement.
    Therefore, it is necessary to initiate salvage RT when PSA levels are low, which reduces the risk of
    future prostate cancer metastasis.

    Original source:

    Emerson E Lee, Tanmay Singh, Chen Hu et al.
    The impact of salvage radiotherapy initiation at PSA ≤ 0.
    5 ng/ml on metastasis-free survival in patients with relapsed prostate cancer following prostatectomy.
    Prostate.
    Oct 2022

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