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Wang CJ, Ying J, Kapur P, et al. Solitary recurrence of castration-resistant prostate cancer with low or undetectable levels of prostate specific antigen salvaged with local ablative radiation therapy: A case report. Oncol Lett. 2015;11(1):713-716doi: 10.3892/ol.2015.3940.
Wang, C. J., Ying, J., Kapur, P., Wohlfeld, B., Roehrborn, C., & Kim, D. W. (2016). Solitary recurrence of castration-resistant prostate cancer with low or undetectable levels of prostate specific antigen salvaged with local ablative radiation therapy: A case report. Oncology letters, 11(1), 713-716. https://doi.org/10.3892/ol.2015.3940
Wang, Chiachien Jake, et al. "Solitary recurrence of castration-resistant prostate cancer with low or undetectable levels of prostate specific antigen salvaged with local ablative radiation therapy: A case report." Oncology letters vol. 11,1 (2016): 713-716. doi: https://doi.org/10.3892/ol.2015.3940
Wang CJ, Ying J, Kapur P, Wohlfeld B, Roehrborn C, Kim DW. Solitary recurrence of castration-resistant prostate cancer with low or undetectable levels of prostate specific antigen salvaged with local ablative radiation therapy: A case report. Oncol Lett. 2016 Jan;11(1):713-716. doi: 10.3892/ol.2015.3940. Epub 2015 Nov 18. PMID: 26870272; PMCID: PMC4727102.
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Oncol Lett. 2016 Jan;11(1):713-716. doi: 10.3892/ol.2015.3940. Epub 2015 Nov 18.

Solitary recurrence of castration-resistant prostate cancer with low or undetectable levels of prostate specific antigen salvaged with local ablative radiation therapy: A case report.

Oncology letters

Chiachien Jake Wang, James Ying, Payal Kapur, Bryan Wohlfeld, Claus Roehrborn, Dong W Nathan Kim

Affiliations

  1. Department of Radiation Oncology, University of Texas, Southwestern Medical Center, Dallas, TX 75390, USA.
  2. Department of Pathology, University of Texas, Southwestern Medical Center, Dallas, TX 75390, USA.
  3. Department of Neurosurgery, University of Texas, Southwestern Medical Center, Dallas, TX 75390, USA.
  4. Department of Urology, University of Texas, Southwestern Medical Center, Dallas, TX 75390, USA.
  5. Department of Radiation Oncology, Texas Oncology, Waco, TX 76712, USA.

PMID: 26870272 PMCID: PMC4727102 DOI: 10.3892/ol.2015.3940

Abstract

Prostate cancer recurrences are usually first detected by increased levels of prostate specific antigen (PSA), and systemic therapy is often initiated if distant metastasis is confirmed. However, low or nearly undetectable levels of PSA in the modern era of ultrasensitive PSA assay may be difficult to interpret in patients with a history of prostate cancer. Deciding whether to initiate additional systemic therapy in limited indolent metastatic disease while balancing the quality of life of the patient and ensuring the oncologic control of the disease may be challenging. In the present study, the case of a biopsy-confirmed solitary spine recurrence of prostate cancer with nearly undetectable but persistent levels of PSA (0.05 ng/ml) is reported. Treatment of the recurrence with local ablative radiotherapy improved the pain experienced by the patient, and reduced his levels of PSA to undetectable limits (<0.05 ng/ml). Repeated imaging analysis, PSA assay and clinical assessment demonstrated durable control of the disease without the requirement for additional systemic treatments. The present case highlighted the importance of initiating appropriate work-up according to the clinical scenario. Local treatment for solitary or oligometastatic recurrence of prostate cancer may enhance the effectiveness of current therapeutic strategies and benefit certain patients.

Keywords: oligometastasis; prostate cancer; salvage therapy; stereotactic body radiotherapy; undetectable prostate specific antigen

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