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Results of three dimensional conformal radiotherapy and hormonal therapy for local recurrence after radical prostatectomy.

Schwarz R, Krüll A, Tribius S, Alberti W

Klinik für Strahlentherapie und Radioonkologie, Universitätskrankenhaus Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany. rschwarz@uke.uni-hamburg.de

BACKGROUND AND PURPOSE: Analysis of treatment results of combined three-dimensional conformal radiotherapy (3DCRT) and hormonal therapy in patients with locally recurrent prostate cancer after radical prostatectomy. PATIENTS AND METHODS: Between 1992 and 1998, 24 patients presented with a rising prostate-specific antigen (PSA) between 4 and 152 months following radical prostatectomy and a local recurrence demonstrated by imaging. Recurrence was biopsy-proven in 13 cases. All patients were treated with 3DCRT to a total dose of 60-70 Gy. 21 patients (88%) received adjuvant hormone therapy up to a maximum of 6 months. RESULTS: All patients showed a response in PSA values after therapy. Median follow-up is 43 months. Overall survival is 80% and 67% at 3 and 5 years, respectively. Biochemical control rates are 53% and 38% at 3 and 5 years, respectively. 14 patients developed a second PSA relapse. Acute and late toxicities, classified with the RTOG score, were moderate. CONCLUSION: Radiotherapy and short-term adjuvant hormone therapy represent an effective and well-tolerated treatment for locally recurrent prostate cancer after radical prostatectomy resulting in good local control. Long-term prognosis in terms of biochemical control and disease-specific survival remains poor.

Published 4 July 2005 in Strahlenther Onkol, 181(7): 442-7.
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