前立腺全摘術後(pT3)のPSA再発に対する放射線治療(Salvage radiotherapy)

Abstract

PSA再発を来した前立腺全摘後(pT3)症例に対して放射線治療(salvage radiotherapy)を行ない, その治療成績について検討した.対象は局所へのsalvage radiotherapy を施行後, 6ヵ月以上の経過観察した13例であった.salvage radiotherapy後, 10例においてPSAの持続的低下が得られ, 生化学的再発を認めなかった.また3年生化学非再発率は74%であった.3次元原体照射法におけるsalvage radiotherapyは重篤な合併症も認めず, 有効な治療法と考えられた

We assessed the effectiveness of salvage radiotherapy in 13 patients at pathologic stage T3 (pT3) with prostate specific antigen (PSA) failure after radical prostatectomy: 9 patients at pT3a and 4 patients at pT3b. Three-dimensional dynamic conformal radiotherapy was used for all patients in this study, and the median radiation dose was 57.7 Gy (range, 44-70 Gy) in daily amounts of 2 Gy. The median follow-up after salvage radiotherapy was 643 days (range, 193-1562 days). In 12 of the 13 patients, PSA levels decreased after salvage radiotherapy, but in 1 patient, the PSA level increased and hence the treatment was discontinued at 44 Gy. However, 10 patients exhibited a lasting PSA response. The 3-year biochemical progression-free rate was 74%, and no serious acute or late toxicity was observed during the follow-up. Salvage radiotherapy is likely to become one of the effective treatments for the patients at pT3 with PSA failure following radical prostatectomy.