The Safety and Efficacy of Salvage Stereotactic Radiation Therapy in Patients with Intraprostatic Tumor Recurrence After Previous External Radiation Therapy: Phase 1 Results from the GETUG-AFU 31 Study

Pasquier, David; Lacornerie, T.; Supiot, S.; Pommier, P.; Quivrin, Magali; Simon, Jean‐Marc; Loos, G.; Meyer, E.; Calais, G.; Peiffert, D.; Vandendorpe, B.; Aymes, Estelle; Leguillette, Clémence; Brihoum, Meryem; Nénan, Soazig; Cormier, L.; Deley, Marie‐Cécile Le; Lartigau, Éric

doi:10.1016/j.euo.2023.01.009

Cited by 10 publications

(13 citation statements)

References 23 publications

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“…Toxicity scoring was done using the RTOG/EORTC toxicity scoring system in two publications (23, 29) and the CTCAE scoring system (versions 3 to 5) in nine publications (25-28, 31, 33, 40-42). In two publications, CTCAE was used for acute toxicity while RTOG was used for late toxicity (24, 32).…”

Section: Resultsmentioning

confidence: 99%

“…Of the remaining 322 records used for screening, another 284 were excluded because no data on reirradiation after initial treatment for PCA and/or no outcome data was reported, resulting in 38 records. In the final step, 14 papers included data on patients treated with SBRT for radiorecurrent prostate cancer after primary radiotherapy and were selected for the Systematic Review while 24 papers were removed during this step (23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(40)(41)(42). Figure 1 shows the consort diagram of the study selection process.…”

Section: Selected Studiesmentioning

confidence: 99%

“…Noticeably, earlier studies on SBRT for radiorecurrent prostate cancer were often done using a Cyberknife treatment machine (9,10,(12)(13)(14)(15)(16). In the last years, however, there has been increasing evidence on prostate re-irradiation using a C-arm LINAC or a MR LINAC (17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33).…”

Section: Introductionmentioning

confidence: 99%

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Re-irradiation to the Prostate using stereotactic body radiotherapy (SBRT) after initial definitive Radiotherapy – A systematic review and Meta-analysis of recent trials

Schröder,

Tang,

Buchali

et al. 2024

Preprint

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Background: There is increasing data on re-irradiation to the prostate using stereotactic body radiotherapy (SBRT) after definite radiotherapy for prostate cancer. There has been increasing evidence on prostate re-irradiation using a C-arm LINAC or a MR LINAC in the last years. We therefore conducted this systematic review and meta-analysis on prostate re-irradiation including studies published from 2020-2023 to serve as an update on existing meta-analysis. Methods: We searched the Pubmed and Embase databases in October 2023 with queries including combinations of "repeat", "radiotherapy", "prostate", "re-irradiation", "reirradiation", "re treatment", "SBRT", "retreatment". Publication date was set to be from 2020 to 2023. There was no limitation regarding language. We adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations. After data extraction, heterogeneity testing using I2. Afterwards a random effects model with a restricted maximum likelihood estimator was used for estimating the combined effect. Funnel plot asymmetry was assessed visually and using Eggers test to estimate the presence of publication and/or small study bias. Results: 14 publications were included in the systematic review. The rates of acute ≥ grade 2 (G2) GU and GI toxicities reported in the included studies range from 0.0-30.0% and 0.0-25.0% respectively. For late ≥G2 GU and GI toxicity, those values are 4.0-51.8% and 0.0-25.0%. The pooled rate of acute GU and GI toxicity ≥G2 were 13% (95% CI: 7-18%) and 2% (95% CI: 0-4%). For late GU and GI toxicity ≥G2 the pooled rates were 25% (95% CI: 14-35%) and 5% (95% CI: 1-9%). The pooled 2-year biochemical recurrence-free survival was 72% (95% CI: 64-92%). Conclusions: SBRT in the re-irradiation of radiorecurrent prostate cancer is overall safe and effective also when applied with a C-arm Linac or an MR Linac. Further prospective data are warranted.

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Section: Resultsmentioning

confidence: 99%

Section: Selected Studiesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Re-irradiation to the Prostate using stereotactic body radiotherapy (SBRT) after initial definitive Radiotherapy – A systematic review and Meta-analysis of recent trials

Schröder,

Tang,

Buchali

et al. 2024

Preprint

View full text Add to dashboard Cite

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“…advances in treatment planning and inter-and intra-fraction image guidance have led to considerable recent interest in SBRT. However, currently available series of SBRT generally have smaller sample sizes and shorter follow-up [24][25][26][27][28][29][30][31][32][33][34]. The MASTER meta-analysis of salvage local therapy studies showed that re-irradiation has similar efficacy to the non-reirradiation modalities, but at a lower risk of toxicity [13].…”

Section: Discussionmentioning

confidence: 99%

“…While most series have explored brachytherapy as the re‐irradiation approach due to the lower integral dose to the surrounding previously irradiated tissues as a result of direct placement of the radiation source into the tumour, advances in treatment planning and inter‐ and intra‐fraction image guidance have led to considerable recent interest in SBRT. However, currently available series of SBRT generally have smaller sample sizes and shorter follow‐up [24–34]. The MASTER meta‐analysis of salvage local therapy studies showed that re‐irradiation has similar efficacy to the non‐re‐irradiation modalities, but at a lower risk of toxicity [13].…”

Section: Discussionmentioning

confidence: 99%

F‐SHARP: a Phase I/II trial of focal salvage high‐dose‐rate brachytherapy for Radiorecurrent prostate cancer

et al. 2023

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BackgroundIntraprostatic local radiorecurrence (LRR) after definitive radiation is being increasingly identified due to the implementation of molecular PET/CT imaging into workup for biochemical recurrence. Salvage high dose rate (HDR) brachytherapy offers a promising local therapy option, with encouraging toxicity and efficacy based on early series. Furthermore, the incorporation of advanced imaging allows for focal HDR to further reduce toxicity to maximize the therapeutic ratio. The objectives of F‐SHARP are to determine the acute and late toxicity and efficacy outcomes of focal salvage HDR brachytherapy for LRR prostate cancer.Study DesignF‐SHARP is a multi‐institutional two‐stage phase I/II clinical trial of salvage focal HDR brachytherapy for LRR prostate cancer enrolling patients at 3 centers.EndpointsThe primary endpoint is the acute radiation‐related grade ≥3 CTCAE v4.03 GU and GI toxicity rate, defined as within 3 months of brachytherapy. Secondary endpoints include acute and late CTCAE v4.03 toxicity, biochemical failure, patterns of clinical progression, disease‐specific and overall survival, and health‐related quality of life, as measured by the IPSS and EPIC‐26 instruments.Patients and MethodsKey eligibility criteria include: biopsy‐proven LRR prostate adenocarcinoma after prior definitive radiation therapy using any radiotherapeutic modality, no evidence of regional or distant metastasis, and cT1‐3a Nx or N0 prostate cancer at initial treatment. All patients will have multiparametric MRI and molecular PET imaging if possible.In Stage 1, 7 patients will be accrued. If there are ≥2 GI or GU grade ≥3 toxicities, the study will be stopped. Otherwise, 17 additional patients will be accrued (total of 24 patients). For Stage 2, the cohort will expand to 62 subjects to study the efficacy outcomes, long‐term toxicity profile, quality of life, and compare single vs. multi‐fraction HDR. Transcriptomic analysis of recurrence biopsies will be performed to identify potential prognostic and predictive biomarkers.Trial Registration: NCT03312972

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Systematic review and recommendations for re-irradiation for intraprostatic radiorecurrent prostate cancer after definitive radiation therapy

Saripalli,

Venkatesulu,

Nickols

et al. 2024

World J Urol

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The Safety and Efficacy of Salvage Stereotactic Radiation Therapy in Patients with Intraprostatic Tumor Recurrence After Previous External Radiation Therapy: Phase 1 Results from the GETUG-AFU 31 Study

Cited by 10 publications

References 23 publications

Re-irradiation to the Prostate using stereotactic body radiotherapy (SBRT) after initial definitive Radiotherapy – A systematic review and Meta-analysis of recent trials

Re-irradiation to the Prostate using stereotactic body radiotherapy (SBRT) after initial definitive Radiotherapy – A systematic review and Meta-analysis of recent trials

F‐SHARP: a Phase I/II trial of focal salvage high‐dose‐rate brachytherapy for Radiorecurrent prostate cancer

Systematic review and recommendations for re-irradiation for intraprostatic radiorecurrent prostate cancer after definitive radiation therapy

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