Salvage Stereotactic Reirradiation for Local Recurrence in the Prostatic Bed After Prostatectomy: A Retrospective Multicenter Study

Archer, P. D.; Marvaso, Giulia; Detti, Beatrice; Colombo, Francesca; Vandendorpe, B.; Thananayagam, Marie Albert; Baty, Manon; Crevoisier, R. de; Alongi, Filippo; Nicosia, Luca; Scher, N.; Tolédano, A.; Muzio, N. Di; Fodor, Andrei; Zilli, Thomas; Franzese, Ciro; Scorsetti, Marta; Shelan, Mohamed; Triggiani, Luca; Aymes, Estelle; Deley, Marie‐Cécile Le; Jereczek‐Fossa, Barbara Alicja; Pasquier, David

doi:10.1016/j.euo.2023.03.005

Cited by 7 publications

(2 citation statements)

References 29 publications

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“…For patients with localized radiorecurrent PCa, local salvage therapy offers patients an opportunity of a definitive cure and potential to avoid the side effects associated with systemic therapies and ADT [2,[5][6][7]. Multiple local salvage therapies are available for patients with radiorecurrent PCa, including salvage radical prostatectomy (sRP), salvage ablative therapies (including cryoablation and high-intensity focused ultrasound (HIFU), and repeat RT with stereotactic body radiotherapy (SBRT), brachytherapy (BT) or EBRT [7,8].…”

Section: Introductionmentioning

confidence: 99%

“…The decision of whether to pursue local salvage therapy, whether to consider additional metastasis-directed therapy, and which salvage technique(s) to pursue should be an individualized, shared decision between the patient and their clinician(s). Advancements in local salvage therapies including cryoablation, HIFU, SBRT, and BT resulted in acceptable short-to-mid-term oncological and favorable functional outcomes in patients with localized radiorecurrent PCa; however, salvage treatment is still associated with higher risks of complications and worse quality of life outcomes than primary treatment [6][7][8]. Therefore, given these higher risks and toxicities associated with salvage therapy, patient selection for local salvage therapy is critically important.…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of Recurrent Disease after Radiation Therapy for Patients Considering Local Salvage Therapy: Past vs. Contemporary Management

Adams,

Deivasigamani,

Mottaghi

et al. 2023

Cancers

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Recurrent prostate cancer after primary treatment with radiation therapy is a common problem. Patients with localized recurrence may benefit from salvage therapy, but careful patient selection is crucial because not all patients will benefit from local salvage therapy, and salvage therapy has increased morbidity compared to primary treatments for prostate cancer. This review aims to provide an overview of the evaluation of patients with recurrent disease after radiation therapy and how it is continuing to evolve with increasing data on outcomes, as well as improving technologies and techniques. Our enhanced understanding of treatment outcomes and risk stratification has influenced the identification of patients who may benefit from local salvage treatment. Advances in imaging and biopsy techniques have enhanced the accuracy of locating the recurrence, which affects treatment decisions. Additionally, the growing interest in image-targeted ablative therapies that have less morbidity and complications than whole-gland therapies for suitable patients influences the evaluation process for those considering focal salvage therapy. Although significant changes have been made in the diagnostic evaluation of patients with recurrent disease after radiation therapy, it remains unclear whether these changes will ultimately improve patient outcomes.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Evaluation of Recurrent Disease after Radiation Therapy for Patients Considering Local Salvage Therapy: Past vs. Contemporary Management

Adams,

Deivasigamani,

Mottaghi

et al. 2023

Cancers

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Stereotactic body radiotherapy (SBRT) re-irradiation for local failures following radical prostatectomy and post-operative radiotherapy

Majewski,

Miszczyk,

Graupner

et al. 2023

Strahlenther Onkol

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Purpose Local recurrences after radical prostatectomy (RP) and postoperative radiotherapy (RT) are challenging for salvage treatment. Retrospective analysis of own experiences with salvage re-irradiation was performed. Methods The study included all consecutive patients treated with salvage stereotactic body radiotherapy (sSBRT) for prostate bed recurrence following RP and postoperative RT at a single tertiary center between 2014 and 2021. Treatment toxicity defined as the occurrence of CTCAE grade ≥ 2 genito-urinary (GU) or gastro-intestinal (GI) adverse events (AEs) was assessed. A PSA response, biochemical control (BC) and overall survival (OS) were also evaluated. Results The study group included 32 patients with a median age of 68 years and a median follow-up of 41 months, treated with CyberKnife (53%) or Linac (47%) sSBRT. Total dose of 33.75–36.25 Gy in five fractions (72%) was applied in the majority of them. Approximately 19% patients reported grade ≥ 2 GU AEs both at baseline and at three months, and grade ≥ 2 GI toxicity increased from 0% at baseline to 6% at three months after sSBRT. There was some clinically relevant increase in late toxicity with 31% patients reporting late ≥ 2 GU, and 12.5% late ≥ 2 GI AEs. Two grade 3 AEs were recorded: recto-urinary fistulas. The majority of patients showed a PSA response (91% at one year post-sSBRT). The 3‑year BC was 40% and 3‑year OS was 87%. Conclusions Manageable toxicity profile and satisfactory biochemical response suggest that SBRT in patients with local recurrence following RP and postoperative RT might be a salvage option for selected patients.

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Stereotactic body radiation therapy after radical prostatectomy: current status and future directions

Le Guevelou,

Magne,

Counago

et al. 2023

World J Urol

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Salvage Stereotactic Reirradiation for Local Recurrence in the Prostatic Bed After Prostatectomy: A Retrospective Multicenter Study

Cited by 7 publications

References 29 publications

Evaluation of Recurrent Disease after Radiation Therapy for Patients Considering Local Salvage Therapy: Past vs. Contemporary Management

Evaluation of Recurrent Disease after Radiation Therapy for Patients Considering Local Salvage Therapy: Past vs. Contemporary Management

Stereotactic body radiotherapy (SBRT) re-irradiation for local failures following radical prostatectomy and post-operative radiotherapy

Stereotactic body radiation therapy after radical prostatectomy: current status and future directions

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