Radiation therapy after surgery for men with prostate cancer lessens the chance of the cancer returning

Radiation therapy after surgery for men with prostate cancer lessens the chance of the cancer coming back, regardless of whether the radiation was administered immediately after surgery or after the cancer recurred, according to a new study in the June 2004 issue of the International Journal of Radiation Oncology*Biology*Physics, the official journal of ASTRO, the American Society for Therapeutic Radiology and Oncology.

Many studies recently have shown that radiation after surgery reduces that chances that the prostate cancer will recur. For prostate cancer, there are two main types of postoperative radiation therapy – adjuvant and salvage. Adjuvant is administered after the primary treatment (in this case, surgery) has been completed and it appears the cancer cells have been killed. Salvage is administered if prostate cancer has started to come back and the physician is trying to save the patient by treating the disease with radiation therapy. In this study, the researchers wanted to see which type of postoperative radiation therapy was best for men with prostate cancer.

Between 1989 and 1997, 69 patients were referred for adjuvant radiation therapy and 88 patients with evidence of a recurrence were treated with salvage radiation therapy. The men in the salvage group received radiation, on average, 40 months after surgery while the patients in the adjuvant group were treated with radiation an average of three months post surgery. According to the study, salvage radiation therapy was significantly less effective when the patient’s PSA level rose over 1.

“The PSA level was the key factor in this study,” said Michael Hagan, M.D., Ph.D., the lead author of the study and a member of the Department of Radiation Oncology at the Medical College of Virginia Hospitals in Richmond. “Today, practitioners follow prostatectomy patients very closely. As a result, salvage radiation therapy is usually initiated quite early. The results from both centers in the study were excellent when radiation treatment was initiated while the serum PSA level was less than 1 ng/ml.”

Dr. Hagan added, “This study shows that the policy for salvage radiation therapy is likely to be as effective as adjuvant radiation therapy only when the institution or practitioner monitors the patient’s PSA level very closely after prostatectomy.”

ASTRO is the largest radiation oncology society in the world, with more than 7,500 members who specialize in treating patients with radiation therapies. As a leading organization in radiation oncology, biology and physics, the Society is dedicated to the advancement of the practice of radiation oncology by promoting excellence in patient care, providing opportunities for educational and professional development, promoting research and disseminating research results and representing radiation oncology in a rapidly evolving socioeconomic healthcare environment.