Radiation treatment benefits men with recurrent prostate cancer

Chances of surviving prostate cancer in men whose tumors recur after prostatectomy are threefold higher for those who undergo radiotherapy within 2 years after recurrence, according to new research findings from the Johns Hopkins Medical Institutions in Baltimore. In men whose new tumors grew fastest, prolonged survival chances were greatest, researchers reported last week in JAMA (2008; 299:2760-9).

“What this new study tells us is that even men with aggressive disease that has recurred after surgery appear to benefit from radiation therapy,” said first author Bruce J. Trock, PhD.

Researchers analyzed records of 635 men who experienced recurrent cancer after radical prostatectomy at Johns Hopkins from June 1982 to August 2004. A total of 397 received no salvage radiation therapy, 160 received only salvage radiation, and 78 were given salvage radiation and hormonal therapy.

Those treated with radiotherapy for prostate cancer recurrence saw an 86% chance of 10-year survival, compared with 62% for those who did not receive radiation. In patients with fast-growing tumors (PSA doubling time of less than 6 months), salvage radiation therapy advantages were apparent, regardless of Gleason score.

“I found the results of this study remarkable," said co-author Patrick C. Walsh, MD. “Previously, we believed that these men, who have aggressive disease defined by a rapid doubling of PSA in 6 months or less, had distant metastases and would not benefit from any form of local salvage therapy.”