Salvage Radiotherapy for Recurrent Prostate Cancer After Radical Prostatectomy

Abstract

Approximately 30 000 men annually in the United States will have recurrence of prostate cancer after radical prostatectomy.¹ Initially, for most of these patients the only evidence of recurrent disease is an increasing serum prostate-specific antigen (PSA) level without radiographic or physical evidence of disease. An estimated 65% of these men will develop bone metastases within 10 years in the absence of salvage therapy.² A rapid PSA doubling time (PSADT), high-grade disease, and a short disease-free interval after radical prostatectomy are prognostic factors associated with the development of metastases in untreated patients with an increasing PSA level.^2-4 However, some patients with an increasing PSA level will have disease initially confined to the pelvis that subsequently may give rise to distant metastases. Isolated local relapse potentially can be cured by salvage radiotherapy, but there is no proven cure for metastatic disease.