Stereotactic body re-irradiation therapy for locally recurrent prostate cancer after external-beam radiation therapy: Initial report

Janoray, G.; Reynaud-Bougnoux, A.; Ruffier-Loubière, A.; Bernadou, G.; Pointreau, Y.; Calais, G.

doi:10.1016/j.canrad.2016.03.005

Cited by 47 publications

(71 citation statements)

References 31 publications

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“…We reached a bNED rate of 55.6% at 14.5 months of median follow-up and a BCR-free survival of 66.7% with reasonable induced toxicity. Janoray et al recently published a report on focal salvage SBRT using CyberKnife® after EBRT failure [31]. In this retrospective study including 11 patients, they reached a biochemical response rate of 82% (9 out of 11 patients).…”

Section: Discussionmentioning

confidence: 74%

Salvage prostate re-irradiation using high-dose-rate brachytherapy or focal stereotactic body radiotherapy for local recurrence after definitive radiation therapy

et al. 2017

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BackgroundOptimal management of locally recurrent prostate cancer after definitive radiation therapy is still challenging. With the development of highly accurate radiotherapy devices, prostate salvage re-irradiation might generate lower toxicity rates than classical salvage therapies. We retrospectively evaluated the toxicity and the feasibility of a prostate re-irradiation after definitive radiation therapy failure. Two modalities were investigated: high-dose-rate brachytherapy (HDRB) on whole prostate gland and focal stereotactic radiotherapy (SBRT) using CyberKnife® linac.MethodsBetween 2011 and 2015, 28 patients with imaged and/or biopsy-proven intra-prostatic recurrence of cancer after definitive radiation therapy underwent a salvage re-irradiation using HDRB (n = 10) or focal SBRT (n = 18). The schedule of re-irradiation was 35 Gy in 5 fractions.Biological response (defined as post-salvage radiation PSA variation) and biochemical no-evidence of disease (bNED) were evaluated in the whole cohort. For patients who had a positive biological response after salvage radiation, biochemical recurrence (BCR) and survival after salvage radiotherapy were evaluated. Post-salvage toxicities were assessed according to the Common Terminology Criteria for Adverse Events (CTCAE) v4.03 and were compared to baseline status.ResultsWithin a median follow-up of 22.5 months (IQR = 8–42), 9 (90%) patients experienced a positive biological response after salvage HDRB and 5 (50%) remained bNED at the end of the follow-up. Among patients who initially responded to salvage HDRB, the BCR rate was 44.4% after a median interval of 19.5 months (IQR = 11.5–26). Only one patient experienced a transient grade 3 urinary complication.In the SBRT group, the median follow-up was 14.5 months (IQR = 7–23) and 10 (55.6%) out of the 18 patients remained bNED. Among the 15 patients who initially responded to salvage SBRT, 5 (33.3%) experienced a BCR. One patient experienced a transient grade 4 urinary complication.At the end of the follow-up, all evaluated patients had a urinary status grade variation ≤ +1 grade. No grade 3–4 digestive toxicity was observed.ConclusionsSalvage prostate re-irradiation for locally recurrent cancer is feasible and generate low toxicities rates when using with HDRB or focal SBRT. However, further investigations are necessary to confirm these findings and to determine predictive features for patients who might benefit from such an approach.

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Section: Discussionmentioning

confidence: 74%

Salvage prostate re-irradiation using high-dose-rate brachytherapy or focal stereotactic body radiotherapy for local recurrence after definitive radiation therapy

et al. 2017

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“…Our excellent rates of GU and GI side effects confirm the good profile of toxicity reported also by other investigators in smaller series. 17,18,20,21,23,25 For example, Leroy et al 20 in a series of 23 patients treated with SBRT (36 Gy in 6 fractions) did not observe Grade 4 or 5 toxicity. Importantly, in our series no patient experienced urinary incontinence, a typical complication of other salvage local therapies.…”

Section: Discussionmentioning

confidence: 98%

“…The efficacy of salvage reirradiation for locally recurrent PCa has been evaluated by several investigations. [14][15][16][17][18][19][22][23][24][25][26][28][29][30][31][32][33][34] The first report on re-EBRT by Vavassori et al 15 including six cases treated by CyberKnife, showed the feasibility of reirradiation with an acceptable rate of acute and early chronic toxicity (median follow-up was 11.3 months). These preliminary findings were then confirmed by the successive series.…”

Section: Discussionmentioning

confidence: 99%

“…14,[16][17][18][19][28][29][30][31][32][33][34] All but one report concluded that salvage re-EBRT is safe. [14][15][16][17][18][19][20][21][23][24][25][26][27] Zilli et al 22 published the data of 14 patients treated with whole prostate reirradiation, with the median follow-up of 94 months, showing low acute but very high late GU and GI toxicity rates (29% of patients experienced combined Grade 4 GU/GI injury). Contrarily to the Zilli's series, we observed only 1 Grade 3 GU event among 20 males with follow-up >36 months.…”

Section: Discussionmentioning

confidence: 99%

“…7,12 As far as reirradiation is concerned, the vast majority of patient series were treated with brachytherapy (BRT). In the last years, along with the improvement in radiotherapy (RT) planning and delivery technology, several reports on salvage EBRT have been published [14][15][16][17][18][19][20][21][22][23][24][25][26][27] (Table 1).…”

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confidence: 99%

See 2 more Smart Citations

Reirradiation for isolated local recurrence of prostate cancer: Mono-institutional series of 64 patients treated with salvage stereotactic body radiotherapy (SBRT)

Jereczek‐Fossa

Rojas

Zerini

et al. 2019

BJR

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PSMA PET‐based stereotactic body radiotherapy for locally recurrent prostate cancer after definitive first‐line therapy

Gruen,

Tegel,

Kluge

et al. 2023

The Prostate

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BackgroundAdvances in prostate‐specific membrane antigen (PSMA) PET–computed tomography (CT) and magnetic resonance imaging (MRI) allow the detection and localization of exclusively local prostate‐cancer‐recurrences after definitive first‐line therapy. PSMA‐based early detection of circumscribed local recurrences followed by hypofractionated high‐precision stereotactic body radiotherapy (SBRT) might yield long‐term disease control at moderate rates of adverse effects.MethodsRetrospective analysis of 35 patients treated for locally recurrent prostate cancer between November 2012 and December 2021 with PSMA PET‐ and MRI‐based robotic SBRT.ResultsThirty‐five patients treated with local prostate cancer recurrence post surgery, post surgery, and adjuvant/salvage radiotherapy (RT) and after definitive RT. All but one patients had fractionated SBRT in 3–5 fractions. Median progression‐free survival (PFS) was 52.2 months for all patients and 52.2 months in the radical prostatectomy (RPE) group, 31.2 months in the RPE + RT group and not reached in the RT group. The most common event was increased urinary frequency grade 1–2. 54.3% of all patients had no acute and 79.4% no late toxicity during follow‐up.DiscussionOur PFS of 52.2 months (RPE), 31.2 months (RPE + RT) and not reached (RT) compares favorably with published data. This method constitutes a valid alternative to morbidity‐prone invasive approaches or palliative systemic therapy.

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Stereotactic body re-irradiation therapy for locally recurrent prostate cancer after external-beam radiation therapy: Initial report

Cited by 47 publications

References 31 publications

Salvage prostate re-irradiation using high-dose-rate brachytherapy or focal stereotactic body radiotherapy for local recurrence after definitive radiation therapy

Salvage prostate re-irradiation using high-dose-rate brachytherapy or focal stereotactic body radiotherapy for local recurrence after definitive radiation therapy

Reirradiation for isolated local recurrence of prostate cancer: Mono-institutional series of 64 patients treated with salvage stereotactic body radiotherapy (SBRT)

PSMA PET‐based stereotactic body radiotherapy for locally recurrent prostate cancer after definitive first‐line therapy

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