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How do you define PSA progression after salvage or adjuvant prostate fossa radiotherapy?
In the recent 10 year update of the ARO (adjuvant pelvic RT versus observation) trial, their definition of PSA failure was 2 successive rises in the PSA. Would not the Phoenix definition/criteria merit a strong consideration as a proven and rational tool to use in these clinical instances - so as to have a common clinical standard of measurement - that is already widely used?
Answer from: Radiation Oncologist at Community Practice
This is an excellent question which in part mixes tradition, clinical practice, and the conduct of clinical trials both on-going and in the past. Fundamentally, from a clinical stand-point the definition of PSA failure should help manage the patient and improve outcome (prolong life, decrease harm s...
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Answer from: Radiation Oncologist at Academic Institution
I pretty much agree with @Daniel A. Hamstra. In the setting of a clinical trial, especially a large multi-institutional study, a definition of failure will emerge that will satisfy the designers of the study, and may represent a compromise amongst people with divergent opinions. In day to day practi...
Answer from: Radiation Oncologist at Community Practice
So - as I see it - in cases of post adjuvant or salvage prostate fossa EBRT - PSA surveillance should follow the now closed RTOG 0534 protocol (version 11/16/2015 - sections 11.3.1 and 11.3.2) method for follow-up - which uses the PSA nadir plus 2ng/ml, and timely follow-up intervals....