AbstractObjective To analyze the clinical efficacy and toxicity of adjuvant (ART) and salvage radiotherapy (SRT) after prostatectomy for prostate carcinoma, and to investigate the variation and significance of prostate-specific antigen (PSA) level. Methods A retrospective study was performed on the clinical data of 58 patients receiving intensity-modulated radiotherapy after prostatectomy from November 2008 to August 2015. In those patients, 21 received ART and 37 SRT. The median dose delivered to the 95% planning target volume (PTV) of the prostate and seminal vesicles tumor bed was 74 Gy,and 95% PTV of the pelvic lymph nodes was 50 Gy. The survival rate was calculated by Kaplan-Meier method. Used Pearson correlation analysis. Results The median follow-up time was 36.2 months. The 3-year biochemical relapse-free survival, tumor-specific survival, and overall survival rates were 81.8%, 100%, and 96%, respectively. In all patients, the median time to PSA nadir after radiotherapy was 3 months with a mean level of PSA nadir of 0.04 ng/ml. In patients treated with ART, the median PSA level before radiotherapy was 0.034 ng/ml;the median time from surgery to radiotherapy was 5.4 months;the mean time to PSA nadir after radiotherapy was 4.6 months. In patients treated with SRT, the median PSA level before radiotherapy was 0.540 ng/ml;the median time from surgery to radiotherapy was 69.7 months;the mean time to PSA nadir after radiotherapy was 9.4 months. The incidence rates of grade 1 and 2 short-term genitourinary (GU) toxicity were 55% and 2%, respectively, while the incidence rates of grade 1 and 2 long-term GU toxicity were 10% and 16%, respectively. The incidence rates of grade 1 and 2 short-term gastrointestinal (GI) toxicity were 30% and 8%, respectively, while the incidence rates of grade 1 and 2 long-term GI toxicity were 9% and 3%, respectively. No patients had grade 3 or 4 toxicity. Rectum D50 was significantly related with acute and late GI side effects (P=0.012、0.026). Conclusions Both ART and SRT achieve satisfactory treatment outcomes and low short-and long-term toxicity. Compared with ART, SRT has a longer time to PSA nadir.
Zhong Qiuzi,Li Gaofeng,Xiu Xia et al. Efficacy of adjuvant and salvage image-guided radiotherapy in post-radical prostatectomy patients[J]. Chinese Journal of Radiation Oncology, 2016, 25(6): 583-587.
Zhong Qiuzi,Li Gaofeng,Xiu Xia et al. Efficacy of adjuvant and salvage image-guided radiotherapy in post-radical prostatectomy patients[J]. Chinese Journal of Radiation Oncology, 2016, 25(6): 583-587.
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2016, Vol. 25 
