What are the effects of salvage stereotactic radiotherapy (SSRT) in prostate cancer relapse after prostate surgery?

This study investigated the effects of salvage stereotactic radiotherapy (SSRT) in patients with prostate bed recurrence after prostate surgery. The main finding was that SSRT was effective at curing or delaying prostate cancer recurrence.

Almost 30% of men who undergo radical prostatectomy (complete removal of the prostate) as a treatment for prostate cancer experience biochemical recurrence. Biochemical recurrence is a rise in the blood level of prostate-specific antigen (PSA; a marker in the blood for prostate cancer or recurrence) in prostate cancer patients after treatment with surgery or radiation. Treatments for biochemical recurrence after radical prostatectomy are called salvage treatments. They have shown varying success among different studies.

Salvage stereotactic radiotherapy (SSRT) gives radiotherapy from many different angles around the body to the area where the tumor was. This means that the tumour receives a high dose of radiation and the tissues around it receive a much lower dose. This may reduce side effects. It is important to evaluate the safety and effectiveness of SSRT in patients with relapse after prostate surgery.

90 patients with biochemical relapse following radical prostatectomy were included in the study. Patients received SSRT at varying levels of radiation. The average dose received was 35 Gy. Medical imaging and blood testing were used to record the effects of treatment. Two PSA levels were set to measure the outcomes of treatment. Biochemical relapse-free survival (BRFS) 1 was defined as an increase of PSA levels greater than 10% of what it was before treatment. BRFS 2 was an increase in PSA levels above 0.2 ng/ml if levels were less than this before treatment. BRFS 2 was also defined as 2 PSA increases of greater than 25% twice in a row.

Before treatment, the average PSA level was 2.3 ng/ml. 19% of patients were also on androgen deprivation (antihormone) therapy ()ADT while receiving SSRT. 39 patients responded completely (PSA levels of less than 0.2 ng/ml). 25 patients experienced BRFS1 after 36.4 months on average. 32 patients experienced BRFS2 after 24.3 months on average. No severe side effects were reported.

This study suggested that SSRT showed optimal biochemical control in patients with prostate cancer recurrence after prostate surgery.

This study included only a small group of patients. Therefore the results may not be applicable to a larger patient population. Further, larger studies are needed.

If you have questions about the treatment of prostate cancer recurrence, please consult a doctor.