Salvage image-guided intensity modulated or stereotactic body reirradiation of local recurrence of prostate cancer

D. Zerini, B. A. Jereczek-Fossa, C. Fodor, F. Bazzani, A. Maucieri, S. Ronchi, S. Ferrario, S. P. Colangione, M. A. Gerardi, M. Caputo, A. Cecconi, F. Gherardi, A. Vavassori, S. Comi, R. Cambria, C. Garibaldi, F. Cattani, O. De Cobelli, R. Orecchia

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Objective: To retrospectively evaluate external beam reirradiation (re-EBRT) delivered to the prostate/prostatic bed for local recurrence, after radical or adjuvant/salvage radiotherapy (RT). Methods: 32 patients received re-EBRT between February 2008 and October 2013. All patients had clinical/radiological local relapse in the prostate or prostatic bed and no distant metastasis. re-EBRT was delivered with selective RT technologies [stereotactic RT including CyberKnifeTM (Accuray, Sunnyvale, CA); image-guidance and intensity-modulated RT etc.]. Toxicity was evaluated using the Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer criteria. Biochemical control was assessed according to the Phoenix definition (NADIR12ngml-1). Results: Acute urinary toxicity: G0, 24 patients; G1, 6 patients; G2, 2 patients. Acute rectal toxicity: G0, 28 patients; G1, 2 patients; and G2, 1 patient. Late urinary toxicity (evaluated in 30 cases): G0, 23 patients; G1, 6 patients; G2, 1 patient. Late renal toxicity: G0, 25 patients; G1, 5 patients. A mean follow-up of 21.3months after re-EBRT showed that 13 patients were free of cancer, 3 were alive with biochemical relapse and 12 patients were alive with clinically evident disease. Four patients had died: two of disease progression and two of other causes. Conclusion: re-EBRT usingmodern technology is a feasible approach for local prostate cancer recurrence offering 2-year tumour control in about half of the patients. Toxicity of re-EBRT is low. Future studies are needed to identify the patients who would benefit most from this treatment. Advances in knowledge: Our series, based on experience in one hospital alone, shows that re-EBRT for local relapse of prostate cancer is feasible and offers a 2-year cure in about half of the patients.

Original languageEnglish
Article number20150197
JournalBritish Journal of Radiology
Issue number1052
Publication statusPublished - Aug 1 2015

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Medicine(all)


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