Median PSA failure-free survival was 72 months (95% CI 41–72 months), while median metastasis-free survival was not reached. Nine patients (13%) developed metastatic castration-resistant disease and died of advanced prostate cancer. Thirty patients (43%) experienced biochemical failure after salvage radiotherapy and 16 patients (23%) experienced metastatic relapse. 5-year PSA failure- and metastasis-free survival rate was 56.9% and 76.9%, respectively. Forty-seven (68%) patients received androgen deprivation therapy (ADT). Thirty-six patients (52.2%) received CFR, 66 Gy in 33 fractions, 2 Gy per fraction, and 33 patients (47.8%) received HFR, 52.5 Gy in 20 fractions, 2.63 Gy per fraction. Sixty-nine patients who had persistent PSA (≥ 0.1 ng/mL) after prostatectomy were identified. Early and late toxicity was assessed using Common Terminology Criteria for Adverse Events (CTCAE) Version 4.0. Cox regression analysis was performed to test association of fractionation regimen and other clinical factors with treatment outcomes. ![]() PSA failure-free and metastasis-free survival were calculated using Kaplan–Meier method. Between May 2012 and December 2016, 147 patients received salvage postprostatectomy radiotherapy. Single institution retrospective chart review was performed after Institutional Review Board approval. Herein we report outcomes for conventionally fractionated (CFR) and hypofractionated radiotherapy (HFR) in patients with persistent postprostatectomy PSA who received salvage radiotherapy to prostate bed. Additionally, patients with persistent PSA after prostatectomy may have aggressive disease and respond less well on standard salvage treatment. ![]() Hypofractionated post-prostatectomy radiotherapy is emerging practice, however with no randomized evidence so far to support it’s use.
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