1. Stereotactic Re-irradiation in Recurrent Prostate Cancer after Previous Postoperative or Definitive Radiotherapy: Long-term Results after a Median Follow-up of 4 Years
- Author
-
G. Stocchi, B. Guerrieri, L. Masi, M. Valzano, Mauro Loi, Lorenzo Livi, L.P. Ciccone, M. Aquilano, Beatrice Detti, E. Scoccimarro, Andrea Gaetano Allegra, V. Di Cataldo, Isacco Desideri, A. Peruzzi, Giulio Francolini, I. Morelli, R. Doro, V. Salvestrini, and C. Bellini
- Subjects
Male ,medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,Hazard ratio ,Prostatic Neoplasms ,Androgen Antagonists ,Common Terminology Criteria for Adverse Events ,Radiosurgery ,medicine.disease ,Confidence interval ,Re-Irradiation ,Radiation therapy ,Androgen deprivation therapy ,Prostate cancer ,Oncology ,Median follow-up ,Concomitant ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Radiology ,Neoplasm Recurrence, Local ,business ,Follow-Up Studies - Abstract
Aims In 2018, we published early results from a cohort of patients treated with stereotactic body radiotherapy (SBRT) after previous radiotherapy with definitive or postoperative intent. We sought to provide extended follow-up of this cohort to confirm the safety and efficacy of this approach in a real-world scenario. Materials and methods Fifty patients affected by local relapse after previous definitive or postoperative radiotherapy were treated with SBRT. Treatment provided a total dose of 30 Gy in five fractions. Data about biochemical relapse-free survival (BRFS) and metastasis-free survival (MFS), together with adverse events, were analysed. Toxicity was reported according to Common Terminology Criteria for Adverse Events (CTCAE) score v.4.03. Results After a median follow-up of 48.2 months, the median BRFS was 43 months. A Gleason score >7 and concomitant androgen deprivation therapy were shown to be predictors of the worst BRFS (hazard ratio 2.42, 95% confidence interval 1.09–5.41, P = 0.02; hazard ratio 2.83, 95% confidence interval 1.17–6.8, P = 0.02, respectively). The median MFS was not reached; concomitant androgen deprivation therapy was confirmed to be predictive of the worst MFS (hazard ratio 4.75, 95% confidence interval 1.52–14.8, P = 0.007). Late grade 1 and 2 rectal and bladder toxicity occurred in three (6%) and 13 (26%) patients, respectively. One patient experienced both grade 3 acute and chronic bladder toxicity. Conclusion Salvage SBRT re-irradiation after previous postoperative or definitive radiotherapy for local prostate cancer recurrence confirmed promising results in terms of oncological outcomes and the safety of this approach.
- Published
- 2022
- Full Text
- View/download PDF