Objective: To retrospectively evaluate external beam reirradiation (re-EBRT) delivered to the prostate/prostatic bed for local recurrence, after radical or adjuvant/salvage radiotherapy (RT). Methods: 32 patients received re-EBRT between February 2008 and October 2013. All patients had clinical/radiological local relapse in the prostate or prostatic bed and no distant metastasis. re-EBRT was delivered with selective RT technologies [stereotactic RT including CyberKnifeTM (Accuray, Sunnyvale, CA); image-guidance and intensity-modulated RT etc.]. Toxicity was evaluated using the Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer criteria. Biochemical control was assessed according to the Phoenix definition (NADIR12ngml-1). Results: Acute urinary toxicity: G0, 24 patients; G1, 6 patients; G2, 2 patients. Acute rectal toxicity: G0, 28 patients; G1, 2 patients; and G2, 1 patient. Late urinary toxicity (evaluated in 30 cases): G0, 23 patients; G1, 6 patients; G2, 1 patient. Late renal toxicity: G0, 25 patients; G1, 5 patients. A mean follow-up of 21.3months after re-EBRT showed that 13 patients were free of cancer, 3 were alive with biochemical relapse and 12 patients were alive with clinically evident disease. Four patients had died: two of disease progression and two of other causes. Conclusion: re-EBRT usingmodern technology is a feasible approach for local prostate cancer recurrence offering 2-year tumour control in about half of the patients. Toxicity of re-EBRT is low. Future studies are needed to identify the patients who would benefit most from this treatment. Advances in knowledge: Our series, based on experience in one hospital alone, shows that re-EBRT for local relapse of prostate cancer is feasible and offers a 2-year cure in about half of the patients.

Salvage image-guided intensity modulated or stereotactic body reirradiation of local recurrence of prostate cancer / D. Zerini, B.A. Jereczek-Fossa, C. Fodor, F. Bazzani, A. Maucieri, S. Ronchi, S. Ferrario, S.P. Colangione, M.A. Gerardi, M. Caputo, A. Cecconi, F. Gherardi, A. Vavassori, S. Comi, R. Cambria, C. Garibaldi, F. Cattani, O. De Cobelli, R. Orecchia. - In: BRITISH JOURNAL OF RADIOLOGY. - ISSN 0007-1285. - 88:1052(2015 Aug), pp. 20150197.1-20150197.7. [10.1259/bjr.20150197]

Salvage image-guided intensity modulated or stereotactic body reirradiation of local recurrence of prostate cancer

B.A. Jereczek-Fossa
Secondo
;
A. Maucieri;S. Ronchi;O. De Cobelli
Penultimo
;
R. Orecchia
Ultimo
2015

Abstract

Objective: To retrospectively evaluate external beam reirradiation (re-EBRT) delivered to the prostate/prostatic bed for local recurrence, after radical or adjuvant/salvage radiotherapy (RT). Methods: 32 patients received re-EBRT between February 2008 and October 2013. All patients had clinical/radiological local relapse in the prostate or prostatic bed and no distant metastasis. re-EBRT was delivered with selective RT technologies [stereotactic RT including CyberKnifeTM (Accuray, Sunnyvale, CA); image-guidance and intensity-modulated RT etc.]. Toxicity was evaluated using the Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer criteria. Biochemical control was assessed according to the Phoenix definition (NADIR12ngml-1). Results: Acute urinary toxicity: G0, 24 patients; G1, 6 patients; G2, 2 patients. Acute rectal toxicity: G0, 28 patients; G1, 2 patients; and G2, 1 patient. Late urinary toxicity (evaluated in 30 cases): G0, 23 patients; G1, 6 patients; G2, 1 patient. Late renal toxicity: G0, 25 patients; G1, 5 patients. A mean follow-up of 21.3months after re-EBRT showed that 13 patients were free of cancer, 3 were alive with biochemical relapse and 12 patients were alive with clinically evident disease. Four patients had died: two of disease progression and two of other causes. Conclusion: re-EBRT usingmodern technology is a feasible approach for local prostate cancer recurrence offering 2-year tumour control in about half of the patients. Toxicity of re-EBRT is low. Future studies are needed to identify the patients who would benefit most from this treatment. Advances in knowledge: Our series, based on experience in one hospital alone, shows that re-EBRT for local relapse of prostate cancer is feasible and offers a 2-year cure in about half of the patients.
Aged; Aged, 80 and over; Humans; Male; Middle Aged; Multimodal Imaging; Neoplasm Recurrence, Local; Positron-Emission Tomography; Prostatic Neoplasms; Radiosurgery; Radiotherapy, Image-Guided; Radiotherapy, Intensity-Modulated; Reoperation; Retrospective Studies; Salvage Therapy; Tomography, X-Ray Computed
Settore MED/36 - Diagnostica per Immagini e Radioterapia
Settore MED/24 - Urologia
ago-2015
Article (author)
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/352449
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