This retrospective study with a large cohort of patients treated with salvage radiotherapy after prostatectomy suggests that up to 50% of patients may remain free of disease 6 years after treatment if it is instituted before their serum PSA rises above 0.5 ng/ml. The nomogram proposed predicts with reasonable accuracy which patients are more likely to exhibit a favorable response to salvage radiotherapy and may aid in clinical decision-making.
The timing of radiation after prostate cancer surgery is not clearly established yet.
Some people advocate immediate radiation therapy for high risk patients (adjuvant radiation therapy) and other recommend only giving radiation to patients that have recurrent PSA values. Since PSA is made by healthy prostate tissue and prostate cancer cells, a rising PSA after surgery likely means that the cancer is recurrent
This study suggests that starting treatment before a level of 0.5 for a recurrent PSA is more effective than waiting until a higher level.