Radiotherapy for isolated increases in serum XXXX levels after radical prostatectomy.

@entity1 @entity137 @entity5 @entity1486
OBJECTIVE: To assess the outcome of radiotherapy in @entity1 with increased serum @entity1486 ( @entity1486 ) levels 6 months or more after radical prostatectomy. DESIGN: In 27 Mayo Clinic @entity1 , we examined the results of radiotherapy relative to various potentially prognostic factors during a median follow-up of 25 months. MATERIAL AND METHODS: All 27 @entity1 had no nodal involvement at the time of prostatectomy and no clinical evidence of disease, as determined by history, physical examination, a radionuclide bone scan, computed tomography of the abdomen and pelvis, chest roentgenography, complete blood cell counts, and serum chemistry profiles. With use of 10-MV photons and a four-field approach, these @entity1 received irradiation to the prostatic bed (60 to 67 Gy in 1.8- to 2.0-Gy fractions). RESULTS: Levels of @entity1486 initially decreased in 24 of the 27 @entity1 (89%). In 16 of the 27 @entity1 (59%), the @entity1486 level decreased to 0.3 ng/mL or less without hormonal intervention. "Freedom from failure" (defined as the actuarial chance of maintaining a @entity1486 level of 0.3 ng/mL or less) was 58% at 2 years and 48% at 3 years. The response to salvage radiotherapy was more favorable in @entity1 with no @entity5 spread into the seminal vesicles and those with serum @entity1486 levels of less than 1.1 ng/mL at the beginning of radiotherapy than in those with seminal vesicle involvement or higher @entity1486 levels. In addition, @entity1 who received radiation doses of 64 Gy or more had more favorable responses than did those who received lesser doses. Radiotherapy resulted in no severe @entity137 . No @entity1 had clinical evidence of disease at the time of this report. CONCLUSION: Isolated increases in serum @entity1486 after prostatectomy indicate the presence of residual or recurrent disease, and radiotherapy effectively decreases the @entity1486 in approximately half the cases. This result is achieved by eradicating residual or recurrent @entity5 bed.
