698 860
Table 4 – Selected retrospective studies comparing adjuvant and salvage radiotherapy (RT) in prostate cancer patients
Patients (
N
)
Patient characteristics Pre-sRT PSA
(median)
Technique
Concomitant
ADT
Dose
(median)
Study
period
Follow-up
(median)
Outcomes
Ost et al
[30]104 aRT vs 134 sRT GS
>
3 + 4: 28 vs 28%
SVI: 25.8 vs 24.7%
PSM: 23.6 vs 33.7%
>
0.5 ng/ml in
57% of pts
IMRT to the
prostate bed and
seminal vesicles
46% vs 37%
74 Gy vs 76 Gy
1999–2009 36 mo
3-yr PFS: 95 vs 87% for
aRT vs sRT (
p
= 0.08)
3-yr BCR-free
survival: 90 vs 65% for
aRT vs sRT (
p
= 0.002)
Budiharto et al
[25]
130 aRT vs 89 sRT
GS 8–10: 7.7 vs 14.6%
PSM: 35.4 vs 58.4%
0.30 ng/ml
3D-CRT to the
prostate bed and
seminal vesicles
No
60 Gy vs 66 Gy
NA
103 mo vs
121 mo
aRT improved PFS
D’Amico et al
[26]
65 aRT vs 49 sRT
with PSADT
<
10 mo vs 46 sRT
with PSADT 10 mo
GS 8–10: 31 vs 10 vs 28%
PSM: 97 vs 53 vs 59%
SVI: 32 vs 22 vs 20%
NA
3D-CRT to the
prostate bed and
seminal vesicles
NA
64 Gy vs 66.6 Gy 1989–2008 7.7 yr
sRT with PSADT
<
10 mo increased
risk of OM
No differences
between aRT and sRT
with PSADT 10 mo
in OM
Jereczek-Fossa et al
[28]
258 aRT vs 173 sRT SVI: 26.7 vs 15%
PSM: 60.5 vs 33.5%
0.78 ng/ml
The 3D six-field
and 3D-ART
techniques were
used in 25.1% and
74.9% of pts
35% vs 41%
70 Gy
1996–2006 32 mo
vs 30 mo
PFS significantly
longer in pts treated
with aRT (79.8 vs
60.5% at 4 yr;
p
<
0.001)
Mishra et al
[29]
102 aRT vs 74 sRT
GS 8–10: 25.7 vs 29.5%
SVI: 31.1 vs 30.4%
PSM: 81.1 vs 76.8%
0.6 ng/ml
3D-CRT and IMRT
to the bed of the
prostate and
seminal vesicles
14.9% vs 26.8% 66 Gy vs 66.6 Gy 1990–2009 103 mo
10-yr BCR-free
survival: 73 vs 41% for
aRT and sRT
(
p
<
0.001)
10-yr CR-free survival:
98.6 vs. 80.9% for aRT
and sRT (
p
= 0.003)
Detti et al
[27]203 aRT vs 104 sRT GS 8–10: 40.4 vs 51%
SVI: 89.2 vs 77.9%
PSM: 49.8 vs 23.1%
1.73 ng/ml
a3D-CRT to the
prostate bed and
seminal vesicles
14.8% vs 26.0% 66.2 Gy vs 66.8 Gy
a1995–2010 4.9 yr
20.7 vs 31.7% pts
experienced BCR in
the aRT vs sRT groups
(
p
= 0.03)
Fossati et al
[43]243 aRT vs
267 observation sRT
GS 8–10: 27 vs 27%
0.2 ng/ml
Conventional
nonconformal
treatment or 3D-
CRT to the bed of
the prostate bed
and seminal
vesicles
No
60 Gy vs 67 Gy
1996–2009 94 mo
8-yr CR-free survival:
92 vs 91% for aRT vs
sRT (
p
= 0.9)
8-yr OS: 89 vs 92%
(
p
= 0.9)
ADT = androgen deprivation therapy; aRT = adjuvant radiotherapy; GS = Gleason score; IMRT = intensity-modulated radiotherapy; NA = not applicable; OM = overall mortality; PFS = progression-free survival;
PSA = prostate specific antigen; PSADT = prostate specific antigen doubling time; PSM = positive surgical margins; pts = patients; sRT = salvage radiotherapy; SVI = seminal vesicle invasion; 3D-CRT = three-dimensional
conformal radiation therapy.
a
Mean.
E U R O P E A N U R O L O G Y 7 2 ( 2 0 1 7 ) 6 8 9 – 7 0 9
698