Salvage conformal radiotherapy for biochemical recurrent prostate cancer after radical prostatectomy

ABSTRACTObjective: Assess the results of salvage conformal radiotherapy in patients with biochemical failure after radical prostate-ctomy and identify prognostic factors for biochemical recurrence and toxicity of the treatment.Materials and Methods: From June 1998 to November 2001, 35 patients were submitted to conformal radiotherapy forPSA ≥ 0.2 ng/mL in progression after radical prostatectomy and were retrospectively analyzed. The mean dose of radiationin prostatic bed was of 77.4 Gy (68-81). Variables related to the treatment and to tumor were assessed to identify prognosticfactors for biochemical recurrence after salvage radiotherapy.Results: The median follow-up was of 55 months (17-83). The actuarial survival rates free of biochemical recurrence andfree of metastasis at a distance of 5 years were 79.7% e 84.7%, respectively. The actuarial global survival rate in 5 yearswas 96.1%.The actuarial survival rate free of biochemical recurrence in 5 years was 83.3% with PSA pre-radiotherapy ≤ 1,100% when > 1 and ≤ 2, and 57.1% when > 2 (p = 0.023). Dose > 70 Gy in 30% of the bladder volume implied in moreacute urinary toxicity (p = 0.035). The mean time for the development of late urinary toxicity was 21 months (12-51). Dose> 55 Gy in 50% bladder volume implied in more late urinary toxicity (p = 0.018). A patient presented late rectal toxicity of2nd grade.Conclusions: Conformal radiotherapy showed to be effective for the control of biochemical recurrence after radical pros-tatectomy. Patients with pre-therapy PSA ≤ 2 ng/mL have more biochemical control.Key words: prostatic neoplasms; prostate-specific antigen; salvage therapy; radiotherapyInt Braz J Urol. 2006; 32: 416-27