Salvage radiation therapy after radical prostatectomy: long-term results of a prospective study

Background. Salvage radiation therapy (SRT) is the main treatment option for patients with biochemical and/or locoregional recurrence of prostate cancer without signs of distant metastasis after radical prostatectomy (RP). This prospective study demonstrates the long-term results of SRT in this category of patients using modern technologies and radiotherapy techniques.

Aim. To improve the effectiveness of SRT in patients with biochemical recurrence of prostate cancer and no signs of distant metastasis after RP through improvement of radiotherapy techniques and identification of prognostic factors. Materials and methods. A prospective single-center phase II cohort study included patients with biochemical recurrence of prostate cancer and no signs of distant metastasis after RP. All patients underwent traditional or hypofractionated SRT using modern technologies: 3DCRT, IMRT, VMAT, IGRT. Some patients underwent hormone radiation therapy.

Results. Between 2009 and 2018, SRT was performed in 411 patients. Median follow-up was 43 (18–86) months. Three-year and 5-year progression-free survival were 81.3 and 77.6 %, respectively. The value of prostate-specific antigen at the time of treatment initiation, its short doubling period after RP, and recurrence in the regional pelvic lymph nodes are 3 significant adverse prognostic factors.

Conclusion. SRT is the only radical method of treating patients with locoregional recurrence of prostate cancer after RP with favorable long-term oncological results.