Case series on multiple prostate re-irradiation for locally recurrent prostate cancer: something ventured, something gained.

Abstract:

: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.

journal_name

Neoplasma

journal_title

Neoplasma

authors

Volpe S,Jereczek-Fossa BA,Zerini D,Rojas DP,Fodor C,Vavassori A,Romanelli P,Vigorito S,Rondi E,Comi S,Cambria R,Cattani F,Dicuonzo S,De Marco P,Beltramo G,Musi G,De Cobelli O,Marvaso G,Orecchia R

doi

10.4149/neo_2018_180723N520

subject

Has Abstract

pub_date

2019-03-05 00:00:00

pages

308-314

issue

2

eissn

0028-2685

issn

1338-4317

pii

180723N520

journal_volume

66

pub_type

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