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For biochemical failure following prostatectomy, is there a PSA value that would be considered too high to offer local salvage radiotherapy?
On what other factors should be considered in making a treatment recommendation for salvage radiation therapy?
Answer from: Radiation Oncologist at Academic Institution
While I don't advocate an absolute PSA cut-off for offering salvage RT, the evidence would suggest that the higher the PSA, the lower the chance of success, especially for higher grade tumors. Patients with PSAs above 2 or so appear to have a poor prognosis with RT alone, but I would not consider th...
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Answer from: Radiation Oncologist at Academic Institution
I agree with @Mitchell S. Anscher. I would not apply a PSA cut-off. Patients with high PSAs after prostatectomy that rise very slowly and have positive margins can be completely salvaged even when their PSA is above 2 or even higher. In those patients, an MR to look for gross disease is critical as ...
Answer from: Radiation Oncologist at Community Practice
The RTOG 9601 study will soon present it's updated analysis, and for those who can't recall, it included pts with a rPSA of up to 4 ng/mL. They should now have >10y of follow-up to provide us all with some highly meaningful data to better understand how well pts with high rPSA values can do with ...