On 9 October 2002, a 57-year-old male underwent nerve-sparing radical prostatectomy (RP), orchidectomy, vesiculectomy, and bilateral lymphadenectomy for prostate adenocarcinoma. The pre-operative serum PSA was >30 ng/mL. pT3a No Mo was the post-operative TNM classification, G2, 4-5 Gleason, stage III. On 27 January 2003, biochemical recurrence (BCR) (two consecutive values higher than 0.2 ng/mL) was detected [,] with a serum PSA level of 0.60 ng/mL. On 1 April 2003, a PSA level of 1.17 ng/mL was found. From 19 April 2003 to 3 June 2012, intermittent androgen deprivation therapy (IAD) was administered with 250 mg flutamide pills, three pills/day, and an luteinizing hormone-releasing hormone (LHRH) agonist was given subcutaneously once every four weeks. From 3 June 2012 to 12 October 2013, because of increasing serum PSA levels (on 29 May 2012, a PSA of 2.24 ng/mL was found), flutamide was replaced with 50 mg bicalutamide, one pill/day, and an LHRH agonist was given subcutaneously once every four weeks. Because PSA levels continued to increase (on 7 October 2013, a PSA value of 9.85 ng/mL was found), from 12 October 2013 to 15 April 2014, bicalutamide was replaced by 300 mg of cyproterone acetate, which was administered i.m. once a week, and an LHRH agonist was given subcutaneously once every four weeks. A trans-rectal ultrasound on 4 November 2013 and whole body (WB) computed tomography (CT) on 30 November 2013 detected a 27 × 26 mm nodule adherent to the bladder wall, and it was suspected to be local recurrence; this suspicion was confirmed by biopsy. On 17 December 2013, the serum PSA level was 18.28 ng/mL. From 18 April 2014 to 18 June 2014, he received external beam radiotherapy (EBRT; 7000 cGray in total). Following the fractioned EBRT, the serum PSA levels continuously decreased and, on 5 May 2016, the PSA value was 0.24 ng/mL. On 1 June 2016, the patient started cyclic IT, which was consistently administered according to the above-reported schedule. The serum PSA levels further and progressively decreased. On 27 August 2018, 50 months after EBRT, serum PSA was undetectable, and then it fluctuated between 0 and 0.01 ng/mL. The last PSA observation on 5 August 2019 was 0.01 ng/mL.\nA study [] recruited 35 prostate cancer patients submitted to RP. Ten of these patients were pT2a-b N0M0 and 24 pT3a-b N0M0. All 35 patients with a macroscopic histologically-proven local recurrence received 30 Gy (21 patients) or 40 Gy (14 patients) of intensity-modulated brachytherapy (IMBT), combined with 30 Gy of EBRT. In the subgroup of 21 patients, after a mean follow-up of 29 months, PSA progression-free survival (PFS) was 24%, and the mean time interval to a PSA increase was 16 months. In the other subgroup of 14 patients, the mean follow-up was 26 months, the PSA progression-free survival (PFS) was 43%, and the mean time interval to a PSA increase was 10 months. Rising PSA values of <2 to 4 ng/mL have been reported to be predictive factors for successful radiotherapy of local recurrences after RP [,]. In the above-mentioned study, the mean rising PSA prior to salvage radiotherapy was 5.02 ng/mL, while it was 18.28 ng/mL in our reported patient. Moreover, the serum PSA nadir has been reported in the literature to occur 12–24 months after radiotherapy (RT) []; in our patient, it was reached after 50 months and maintained at 62 months.
On 17 December 2007, a 46-year-old female underwent a radical left mastectomy; post-operative histology showed an infiltrating ductal carcinoma with microscopic lesions of ductal carcinoma in situ.\npT2 N3a (14/28) M1 was the post-operative TNM classification, G3, ER+ (90%) Pr+ (90%), Ki67 40%, and HER2 negative. The post-operative work-up, BS and WB CT showed two metastatic lesions involving the left iliac crest and pubic symphysis, respectively, with elevated serum TPA values. From 9 January 2008 to 31 July 2008, she received salvage chemotherapy with six cycles of 5-fluorouracil-epirubicin-cyclophosphamide (FEC) (600/60/600 mg/sqm on days 1 and 28) followed by four cycles of docetaxel (80 mg/sqm every 21 days). From 1 August 2008 to 2 March 2009, she was continuously given 1 mg anastrozole pills (one pill/day). On 2 March 2009, she was recruited for a pilot study, which we have more times reported [,,,], that applied cycles of IT with beta- interferon and interleukin-2 in addition to continuous conventional salvage hormone-therapy. From April to June 2010, clinical examination, bone scanning, and subsequent abdominal CT showed a complete clinical radiological response with normal values of the serum CEA-TPA-CA15.3 tumor marker panel. To date, these normal values have been maintained during intensive post-operative monitoring. In 2015 and 2016, IT cycles were interrupted for four months; in 2017, 2018, and 2019, both IT and concomitant hormone-therapy were interrupted for 7, 6, and 6 months, respectively.\nOccasionally, metastatic breast cancer patients have been reported with more than a 10-year CR following conventional therapy []. However, these studies had relatively poor clinical-radiological documentation [,].