open access

Vol 24, No 5 (2019)
Original research articles
Published online: 2019-09-01
Submitted: 2019-05-01
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Multiparametric magnetic resonance imaging-guided salvage radiotherapy in prostate cancer

Felipe Couñago, Ana Aurora Díaz Gavela, Gemma Sancho, Irene Ortiz, Francisco José Marcos, Manuel Recio, Julio Fernández, Raquel Cano, Mar Jiménez, Israel J. Thuissard, David Sanz-Rosa, Juan Castro Nováis, Eduardo Pardo, Yolanda Molina, Hugo Pérez García, Elia del Cerro
DOI: 10.1016/j.rpor.2019.07.008
·
Rep Pract Oncol Radiother 2019;24(5):472-480.

open access

Vol 24, No 5 (2019)
Original research articles
Published online: 2019-09-01
Submitted: 2019-05-01

Abstract

Aim

To analyse the efficacy and toxicity of postprostatectomy SRT in patients with a BCR evaluated with mpMRI.

Background

Multiparametric magnetic resonance imaging (mpMRI) has the ability to detect the site of pelvic recurrence in patients with biochemical recurrence (BCR) after radical prostatectomy (RP). However, we do not know the oncological outcomes of mpMRI-guided savage radiotherapy (SRT).

Results

Local, lymph node, and pelvic bone recurrence was observed in 13, 4 and 2 patients, respectively. PSA levels were significantly lower in patients with negative mpMRI (0.4ng/mL [0.4]) vs. positive mpMRI (2.2ng/mL [4.1], p=0.003). Median planning target volume doses in patients with visible vs. non-visible recurrences were 76Gy vs. 70Gy. Overall, mean follow-up was 41 months (6–81). Biochemical relapse-free survival (bRFS) at 3 years was 82.3% and 82.5%, respectively, for the negative and positive mpMRI groups (p=0.800). Three-year rates of late grade ≥2 urinary and rectal toxicity were 14.8% and 1.9%, respectively; all but one patient recovered without sequelae.

Conclusion

SRT to the macroscopic recurrence identified by mpMRI is a feasible and well-tolerated option. In this study, there were no differences in bRFS between MRI-positive and MRI-negative patients, indicating effective targeting of MRI-positive lesions.

Abstract

Aim

To analyse the efficacy and toxicity of postprostatectomy SRT in patients with a BCR evaluated with mpMRI.

Background

Multiparametric magnetic resonance imaging (mpMRI) has the ability to detect the site of pelvic recurrence in patients with biochemical recurrence (BCR) after radical prostatectomy (RP). However, we do not know the oncological outcomes of mpMRI-guided savage radiotherapy (SRT).

Results

Local, lymph node, and pelvic bone recurrence was observed in 13, 4 and 2 patients, respectively. PSA levels were significantly lower in patients with negative mpMRI (0.4ng/mL [0.4]) vs. positive mpMRI (2.2ng/mL [4.1], p=0.003). Median planning target volume doses in patients with visible vs. non-visible recurrences were 76Gy vs. 70Gy. Overall, mean follow-up was 41 months (6–81). Biochemical relapse-free survival (bRFS) at 3 years was 82.3% and 82.5%, respectively, for the negative and positive mpMRI groups (p=0.800). Three-year rates of late grade ≥2 urinary and rectal toxicity were 14.8% and 1.9%, respectively; all but one patient recovered without sequelae.

Conclusion

SRT to the macroscopic recurrence identified by mpMRI is a feasible and well-tolerated option. In this study, there were no differences in bRFS between MRI-positive and MRI-negative patients, indicating effective targeting of MRI-positive lesions.

Get Citation

Keywords

Biochemical failure; Multiparametric MRI; Prostate cancer; Radical prostatectomy; Salvage radiotherapy

About this article
Title

Multiparametric magnetic resonance imaging-guided salvage radiotherapy in prostate cancer

Journal

Reports of Practical Oncology and Radiotherapy

Issue

Vol 24, No 5 (2019)

Pages

472-480

Published online

2019-09-01

DOI

10.1016/j.rpor.2019.07.008

Bibliographic record

Rep Pract Oncol Radiother 2019;24(5):472-480.

Keywords

Biochemical failure
Multiparametric MRI
Prostate cancer
Radical prostatectomy
Salvage radiotherapy

Authors

Felipe Couñago
Ana Aurora Díaz Gavela
Gemma Sancho
Irene Ortiz
Francisco José Marcos
Manuel Recio
Julio Fernández
Raquel Cano
Mar Jiménez
Israel J. Thuissard
David Sanz-Rosa
Juan Castro Nováis
Eduardo Pardo
Yolanda Molina
Hugo Pérez García
Elia del Cerro

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