Open AccessCase series on multiple prostate re-irradiation for locally recurrent prostate cancer: something ventured, something gained
Author(s) -
Stefania Volpe,
B.A. Jereczek-Fossa,
Dario Zerini,
Damaris Patricia Rojas,
C. Fodor,
Andrea Vavassori,
P. Romanelli,
S. Vigorito,
E. Rondi,
S. Comi,
Raffaella Cambria,
Federica Cattani,
Samantha Dicuonzo,
Paolo De Marco,
G. Beltramo,
Gennaro Musi,
Ottavio De Cobelli,
Giulia Marvaso,
Roberto Orecchia
Publication year - 2019
Publication title -
neoplasma
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.628
H-Index - 50
eISSN - 1338-4317
pISSN - 0028-2685
DOI - 10.4149/neo_2018_180723n520
Subject(s) - medicine , prostate cancer , prostate , genitourinary system , magnetic resonance imaging , biochemical recurrence , radiation therapy , retrospective cohort study , salvage therapy , radiation treatment planning , nuclear medicine , positron emission tomography , urology , radiology , cancer , chemotherapy , prostatectomy
The aim is to present the technical feasibility and efficacy of multiple re-irradiation (re-EBRT) for local recurrence of prostate cancer (PCa) using retrospective analysis of an updated series of patients who received ablative re-EBRT with stereotactic image-guided technique for isolated local recurrence of PCa. Eight patients received three RT courses (2 re-RTs); of those 2 received 4 RT courses (3 re-RTs). Local relapse in the prostate was assessed by multiparametric magnetic resonance and/ or choline positron emission tomography. Before treatment planning, all patients had been evaluated for late toxicity from previous RT according to RTOG/EORTC. Biochemical control was assessed according to Phoenix definition. Mean age at the third RT course was 68 (standard deviation, SD: 7.2); all patients had a good performance status. At diagnosis, four cases were classified as high risk PCa, three as intermediate and one as low per NCCN 2017. Biochemical progression free interval after first and second RT-course were 74 (IQR: 59.3-133.6) months and 33 (IQR: 20.8-53.1) months, respectively. Biochemical and radiological response was registered in all patients. At present, seven out of eight patients are disease free. Overall toxicity profile was good; no severe acute or late genitourinary or gastrointestinal events were recorded. Multiple RT courses with high precision technology and image guidance can be proposed as a possible salvage therapy for locally recurrent, low-burden PCa recurrence in adequately selected patients. Deeper understanding of radiobiological effects of hypofractionation and larger series of patients are warranted to fully evaluate the applicability of multiple RT courses in the setting of locally recurrent PCa.