Long-term Impact of Adjuvant Versus Early Salvage Radiation Therapy in pT3N0 Prostate Cancer Patients Treated with Radical Prostatectomy: Results from a Multi-institutional Series

Fossati, Nicola; Karnes, R. Jeffrey; Boorjian, Stephen A.; Moschini, Marco; Morlacco, Alessandro; Bossi, Alberto; Seisen, Thomas; Cozzarini, C.; Fiorino, Claudio; Chiorda, B. Noris; Gandaglia, Giorgio; Dell’Oglio, Paolo; Joniau, Steven; Tosco, Lorenzo; Shariat, Shahrokh F.; Goldner, Gregor; Hinkelbein, W.; Bartkowiak, Detlef; Haustermans, Karin; Tombal, Bertrand; Montorsi, Francesco; Poppel, Hein Van; Wiegel, Thomas; Briganti, Alberto

doi:10.1016/j.eururo.2016.07.028

Cited by 87 publications

(47 citation statements)

References 25 publications

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“…Conversely, our findings suggest that the presence of a positive margin should prompt the use of adjuvant RT exclusively in men with adverse PSMs and aggressive pathologic features. On the contrary, a single positive margin shorter than 3 mm should not be considered a driver for the administration of adjuvant therapies if not indicated according to other pathologic characteristics [25,26]. Moreover, implementation of our risk stratification system in clinical practice may lead to the reduction of overtreatment, by means of the administration of adjuvant RT.…”

Section: Discussionmentioning

confidence: 99%

Defining Clinically Meaningful Positive Surgical Margins in Patients Undergoing Radical Prostatectomy for Localised Prostate Cancer

Martini

Gandaglia

Fossati

et al. 2021

European Urology Oncology

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Section: Discussionmentioning

confidence: 99%

Defining Clinically Meaningful Positive Surgical Margins in Patients Undergoing Radical Prostatectomy for Localised Prostate Cancer

Martini

Gandaglia

Fossati

et al. 2021

European Urology Oncology

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“…The 5-year bPFS of 62.7% in the present study is similar or better than those reported in western countries. 12,15,16 This might be due to better selection of patients (most patients started SRT when their PSA level was ≤0.5 ng/mL), or the higher dose of SRT to the prostatic fossa (median 70 Gy). In our cohort, all patients but one were treated using IMRT/VMAT.…”

Section: Discussionmentioning

confidence: 99%

“…All authors had full access to the data, contributed to the study, approved the final version for publication, and take responsibility for its accuracy and integrity. An earlier version of this paper was presented as poster presentation at the 9th European Multidisciplinary Meeting on Urological Cancers, [16][17][18][19] November 2017, Barcelona, Spain.…”

Section: Declarationmentioning

confidence: 99%

Outcomes of salvage radiotherapy for recurrent prostate cancer after radical prostatectomy

et al. 2018

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“…The available evidence supporting the efficacy of salvage RT is based on retrospective series. 20,21 Various phase III trials are currently investigating this including the RAVES, 8 GETUG-17 (NCT00667069) and RADICALS trials (NCT00541047).…”

Section: Oncologic Outcomesmentioning

confidence: 99%

Outcomes of post‐prostatectomy radiotherapy at a Regional Cancer Centre

Nicholls

Winter

Harwood

et al. 2017

J of Medical Radiation Sci

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IntroductionTo investigate the efficacy and toxicity of radiation therapy (RT) after radical prostatectomy (RP) for prostate cancer at Radiation Oncology Centres, Toowoomba.MethodsThe electronic medical records of 130 consecutive patients with histologically proven prostate adenocarcinoma who underwent post‐prostatectomy RT between January 2008 and December 2014 were analysed. Primary endpoint was Biochemical Recurrence (BCR) after RT. BCR was defined by PSA > 0.2 ng/mL and BCR endpoints were analysed using Kaplan–Meier methods. The impact of RT technique and the rates of acute and late toxicities are also reported. Toxicities were graded according to Radiation Therapy Oncology Group (RTOG) criteria.ResultsMedian follow‐up time after RT (regardless of technique) was 28 months. BCR occurred in 32 of the 126 patients (25%) whose prostate specific antigen (PSA) levels have been monitored post‐RT. At 24 and 36 months, 85% and 75% of patients were BCR‐free, respectively. Patients with a pre‐RT PSA above 0.2 ng/mL had a higher probability of recurrence than patients with values below 0.2 ng/mL (P = 0.03). RT technique, pelvic nodal irradiation, androgen deprivation therapy, T staging or surgical margin did not significantly impact BCR results.No patient experienced acute toxicities greater than grade 2. Grade 1 or 2 late gastrointestinal (GI) toxicity occurred in 11% and 1 patient experienced a grade 3 event. 12% of patients developed grade 1 or 2 late genitourinary (GU) toxicity, with evidence of grade 3 severity in only 1 patient. Evidence of a trend in reduction in late GI toxicity with the use of intensity modulated radiation therapy (IMRT) or volumetric modulated arc therapy (VMAT) was apparent but not with late GU toxicity.ConclusionAt our regional centre, early RT (PSA < 0.2 ng/mL) was associated with significant improvement in BCR‐free survival. Rates of toxicity mirror those of landmark trials which suggest no detriment for our regional prostate cancer patients. The use of IMRT/VMAT techniques was associated with a trend towards reduced rates of GI toxicity.

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Long-term Impact of Adjuvant Versus Early Salvage Radiation Therapy in pT3N0 Prostate Cancer Patients Treated with Radical Prostatectomy: Results from a Multi-institutional Series

Cited by 87 publications

References 25 publications

Defining Clinically Meaningful Positive Surgical Margins in Patients Undergoing Radical Prostatectomy for Localised Prostate Cancer

Defining Clinically Meaningful Positive Surgical Margins in Patients Undergoing Radical Prostatectomy for Localised Prostate Cancer

Outcomes of salvage radiotherapy for recurrent prostate cancer after radical prostatectomy

Outcomes of post‐prostatectomy radiotherapy at a Regional Cancer Centre

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