Salvage external beam radiotherapy for recurrent prostate adenocarcinoma after high-intensity focused ultrasound as primary treatment

Fernando Munoz, Alessia Guarneri, Angela Botticella, Pietro Gabriele, Francesco Moretto, Rocco Panaia, Andrea Ruggieri, Leonardo D'Urso, Giovanni Muto, Andrea Riccardo Filippi, Riccardo Ragona, Umberto Ricardi

Research output: Contribution to journalArticlepeer-review

Abstract

Introduction: The main objective was to evaluate feasibility, toxicity and biochemical control rates of salvage external beam radiotherapy (EBRT) in recurrent localized prostate cancer after high-intensity focused ultrasound (HIFU) as primary therapy. Patients and Methods: A total of 24 patients who underwent salvage EBRT after 1 or 2 HIFU sessions and with a minimum post-treatment follow-up of 24 months were retrospectively evaluated. Primary endpoints were toxicity and biochemical disease-free survival (bDFS, defined according to the ASTRO Phoenix definition). Results: Median follow-up was 40.3 months. Gastrointestinal toxicity was low. Acute genitourinary (GU) toxicity grade ≤II rate was 45.8%, with only few patients presenting grade III (8.3%) and grade IV (4.2%) toxicity. Late grade ≥III GU toxicity was registered in 16.7% of patients. The 3-year bDFS rate was 77.8%. Patients achieving a nadir prostate-specific antigen (nPSA) of ≤0.35 ng/ml after EBRT had significantly higher bDFS (3-year bDFS: 87.7 vs. 50%, respectively; p = 0.001). Achieving nPSA ≤0.35 ng/ml was the only factor independently associated to long-term bDFS both on univariate (p = 0.01) and multivariate analysis (HR 7.06, p = 0.039). Conclusions: Salvage EBRT after HIFU failure is feasible and allows to obtain satisfactory biochemical control rates, especially in patients attaining a nPSA ≤0.35 ng/ml after EBRT.

Original languageEnglish
Pages (from-to)288-293
Number of pages6
JournalUrologia Internationalis
Volume90
Issue number3
DOIs
Publication statusPublished - Apr 2013

Keywords

  • High-intensity focused ultrasound relapse
  • Nadirprostate-specific antigen
  • Recurrent prostate adenocarcinoma
  • Salvage external beam radiotherapy
  • Toxicity

ASJC Scopus subject areas

  • Urology

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