Radiotherapy for men with PSA failure following radical prostatectomy

We evaluated the efficacy of salvage external beam radiotherapy (RT) to the prostate bed for men with prostate-specific antigen (PSA) failure following radical prostatectomy. Fourteen patients underwent RT for PSA failure following radical prostatectomy between 1999 and 2000. Median follow-up was 24 months. Median PSA level before RT was 0.51 ng/ml. Radiation dose was 60Gy or 61.4Gy. The 3-year actuarial biochemical disease-free survival (bDFS) rate was 40%. The biochemical effectiveness of RT was better in cases with a PSA level of less than 1 ng/ml compared to that in cases with a level higher than 1 ng/ml. The PSA level before RT and surgical margin involvement were identified as prognostic factors for bDFS. No patients experienced grade 3 toxicity. RT for PSA failure following radical prostatectomy seems to be very effective and was only slightly toxic during a limited follow-up period.