Vol 25, No 2 (2020)
Original research articles
Published online: 2020-03-01

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Helical tomotherapy re-irradiation for patients affected by local radiorecurrent prostate cancer

Cristina Mariucci1, Gianluca Ingrosso1, Vittorio Bini2, Simonetta Saldi3, Marco Lupattelli3, Alessandro Frattegiani3, Elisabetta Perrucci3, Isabella Palumbo1, Lorenzo Falcinelli3, Giuseppe Centofanti1, Rita Bellavita2, Cynthia Aristei1
DOI: 10.1016/j.rpor.2020.01.005
Rep Pract Oncol Radiother 2020;25(2):157-162.

Abstract

Background

Salvage re-irradiation in patients affected by radiorecurrent prostate cancer might be a valid as well as challenging treatment option. The aim of this study was to evaluate feasibility and toxicity of salvage external beam radiotherapy (EBRT) re-treatment in patients affected by radiorecurrent prostate cancer within the prostate gland or the prostate bed.

Materials and Methods

15 patients underwent EBRT re-treatment using helical tomotherapy (HT), with daily Megavolt computed tomography image-guidance. We registered toxicity according to Common Terminology Criteria for Adverse Events (CTCAE) v4.0. Biochemical relapse was defined as a PSA increase > 20% compared with the pre-EBRT re-treatment value. Survival curves were calculated using the Kaplan-Meier method.

Results

All patients received a total dose of 50Gy (25×2Gy), and 7 (46.6%) had concomitant androgen deprivation therapy (median duration of 12 months). With a median follow-up of 40.9 months, the 2-year and 4-year biochemical relapse-free survival were 55% and 35%, respectively. Acute and late genito-urinary (GU) toxicity ≥2 were recorded in 4 (26.6%) and 5 (33.3%) patients, respectively, and the 4-year late GU toxicity was 30%. Acute gastrointestinal toxicity ≥2 was recorded in 2 (13.3%) cases, whereas no patient experienced late toxicity.

Conclusions

Despite the inherent bias of a retrospective analysis, our long-term results showed a low toxicity profile with a relatively low rate of biochemical control for HT re-treatment in patients affected by local radiorecurrent prostate cancer. Prospective trials are needed to investigate the role of EBRT in this setting.

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Reports of Practical Oncology and Radiotherapy