and purpose: To assess the efficacy and safety of salvage stereotactic body radiotherapy (SBRT) in patients with biopsy-proven local prostate cancer recurrence after radiotherapy.
Between April 2010 and January 2017, 100 patients were included in 7 centers. Disease extension was assessed by pelvic multiparametric magnetic resonance imaging and choline positron emission tomography in 87% and 94% of patients, respectively. The median time interval between the two treatments was 7.5 years (range, 2-18). Median PSA at recurrence was 4.3 ng/mL (range, 2-38). Median SBRT dose was 36 Gy (range, 25-36.25) in 6 fractions (range, 5-6), every other day. Thirty-four percent of patients were treated by androgen deprivation therapy for a median duration of 12 months. Toxicity was assessed according to CTCAE v.4.03.
Median follow-up was 29.3 months (range, 4-91). Second biochemical recurrence-free survival rate at 3 years was 55% [95% CI: 42%-66%]. The initial D’Amico group, time interval after first radiotherapy and SBRT dose were prognostic factors of biochemical recurrence-free survival in multivariate analysis (p=0.09, p=0.025, p=0.018, respectively). No patient developed acute gastro-intestinal (GI) toxicity of grade > 1; acute genito-urinary (GU) toxicity of grade 2 and 3 were 8% and 1%, respectively. The actuarial 3-year grade ≥2 GU and GI toxicity was 20.8% (95% CI: 13%-29%) and 1% (95% CI: 0.1%-5.1%), respectively. One patient presented a neuritis of grade 3.
With a short follow up, this study shows that salvage SBRT allows for encouraging control and acceptable toxicity. Further prospective studies are necessary to confirm these preliminary results and to determine late toxicity.
International journal of radiation oncology, biology, physics. 2019 Jul 22 [Epub ahead of print]
David Pasquier, Geoffrey Martinage, Guillaume Janoray, Damaris Patricia Rojas, Dario Zerini, Flora Goupy, Renaud De Crevoisier, Emilie Bogart, Gilles Calais, Alain Toledano, Laurent Chauveinc, Nathaniel Scher, Pierre Yves Bondiau, Jean Michel Hannoun-Levi, Marlon Silva, Emmanuel Meyer, Philippe Nickers, Thomas Lacornerie, Barbara Jereczek-Fossa, Eric Lartigau
Academic Department of Radiation Oncology, Centre Oscar Lambret, F-59000 Lille, France; CRIStAL UMR CNRS 9189, Lille University, F-59000 Lille, France. Electronic address: ., Academic Department of Radiation Oncology, Centre Oscar Lambret, F-59000 Lille, France., Oncology-Radiotherapy Department, Henry-S.-Kaplan Cancer Center, CHRU de Tours, 2, boulevard Tonnelle, F-37000 Tours, France; University François-Rabelais, F-37000 Tours, France., Department of Radiotherapy, European Institute of Oncology and Department of Oncology and Hemato-oncology, University of Milan, Italy., Department of Radiotherapy, Centre Eugène Marquis, F-35000 Rennes., Department of Radiotherapy, Centre Eugène Marquis, F-35000 Rennes; INSERM 1099 Unit, F-35042 Rennes, France; LTSI, Université de Rennes 1, F-35042 Rennes, France., Department of Biostatistics, Centre Oscar Lambret, F-59000 Lille, France., Department of Radiotherapy, Hartmann Radiotherapy Center, F-92300 Levallois-Perret, France., Department of Radiation Oncology, Antoine Lacassagne Cancer Center, University of Cote d’Azur, F-06100 Nice, France., Department of Radiation Oncology, Centre François Baclesse, F-14000, Caen, France., Department of Medical Physics, Centre Oscar Lambret, F-59000 Lille, France., Academic Department of Radiation Oncology, Centre Oscar Lambret, F-59000 Lille, France; CRIStAL UMR CNRS 9189, Lille University, F-59000 Lille, France.