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Published in: World Journal of Urology 3/2016

01-03-2016 | Original Article

CyberKnife stereotactic radiotherapy for isolated recurrence in the prostatic bed

Authors: B. Detti, P. Bonomo, L. Masi, R. Doro, S. Cipressi, C. Iermano, I. Bonucci, D. Franceschini, L. Di Brina, M. Baki, G. Simontacchi, I. Meattini, M. Carini, S. Serni, G. Nicita, L. Livi

Published in: World Journal of Urology | Issue 3/2016

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Abstract

Purpose

To report a clinical experience of stereotactic body radiation therapy (SBRT) for isolated recurrence in the prostatic bed from prostate cancer.

Materials and methods

Between November 2011 and November 2013, 16 patients were treated with SBRT for a macroscopic isolated recurrence of prostate cancer in the prostatic bed. All patients were initially treated with radical prostatectomy, and half of them also received radiotherapy. Two schedules of SBRT were used: 30 Gy in 5 fractions in previously irradiated patients, 35 Gy in five fractions in radiotherapy-naïve patients.

Results

At a median follow-up of 10 months (range 2–21 months), a significant biochemical response was found in all but one patient. At imaging evaluation, no local progression was noted: 10 patients showed partial response while four stable disease. At the moment of analysis, all 16 patients were alive. Seven of them experienced distant relapse, while nine maintained biochemical control, with no further therapy. Median time to relapse was 9.3 months (range 3–15.2 months). The treatment was well tolerated: One patient experienced G2 acute genitourinary and gastrointestinal toxicity.

Conclusions

Our experience shows that SBRT with CyberKnife for isolated nodal relapse is a safe and well-tolerated treatment.
Literature
1.
go back to reference Hagan M, Zlotecki R, Medina C, Tercilla O, Rivera I, Wajsman Z (2004) Comparison of adjuvant versus salvage radiotherapy policies for postprostatectomy radiotherapy. Int J Radiat Oncol Biol Phys 59(2):329–340CrossRefPubMed Hagan M, Zlotecki R, Medina C, Tercilla O, Rivera I, Wajsman Z (2004) Comparison of adjuvant versus salvage radiotherapy policies for postprostatectomy radiotherapy. Int J Radiat Oncol Biol Phys 59(2):329–340CrossRefPubMed
2.
go back to reference Macdonald OK, Schild SE, Vora SA et al (2004) Salvage radiotherapy for palpable, locally recurrent prostate cancer after radical prostatectomy. Int J Radiat Oncol Biol Phys 58(5):1530–1535CrossRefPubMed Macdonald OK, Schild SE, Vora SA et al (2004) Salvage radiotherapy for palpable, locally recurrent prostate cancer after radical prostatectomy. Int J Radiat Oncol Biol Phys 58(5):1530–1535CrossRefPubMed
3.
go back to reference Anscher MS (2004) Salvage radiotherapy for recurrent prostate cancer: the earlier the better. JAMA 291(11):1380–1382CrossRefPubMed Anscher MS (2004) Salvage radiotherapy for recurrent prostate cancer: the earlier the better. JAMA 291(11):1380–1382CrossRefPubMed
4.
go back to reference Tomita N, Kodaira T, Furutani K et al (2009) Early salvage radiotherapy for patients with PSA relapse after radical prostatectomy. J Cancer Res Clin Oncol 135(11):1561–1567CrossRefPubMed Tomita N, Kodaira T, Furutani K et al (2009) Early salvage radiotherapy for patients with PSA relapse after radical prostatectomy. J Cancer Res Clin Oncol 135(11):1561–1567CrossRefPubMed
5.
go back to reference Mottet N, Bellmunt J, Bolla M et al (2011) EAU guidelines on prostate cancer. Part II: treatment of advanced, relapsing and castration-resistant prostate cancer. Eur Urol 59(4):572–583 Mottet N, Bellmunt J, Bolla M et al (2011) EAU guidelines on prostate cancer. Part II: treatment of advanced, relapsing and castration-resistant prostate cancer. Eur Urol 59(4):572–583
7.
go back to reference Alongi F, Arcangeli S, Filippi AR, Ricardi U, Scorsetti M (2012) Review and uses of stereotactic body radiation therapy for oligometastases. Oncologist 17(8):1100–1107PubMedCentralCrossRefPubMed Alongi F, Arcangeli S, Filippi AR, Ricardi U, Scorsetti M (2012) Review and uses of stereotactic body radiation therapy for oligometastases. Oncologist 17(8):1100–1107PubMedCentralCrossRefPubMed
8.
go back to reference Amling CL, Blute ML, Bergstralh EJ, Seay TM, Slezak J, Zincke H (2000) Long-term hazard of progression after radical prostatectomy for clinically localized prostate cancer: continued risk of biochemical failure after 5 years. J Urol 164:101–105CrossRefPubMed Amling CL, Blute ML, Bergstralh EJ, Seay TM, Slezak J, Zincke H (2000) Long-term hazard of progression after radical prostatectomy for clinically localized prostate cancer: continued risk of biochemical failure after 5 years. J Urol 164:101–105CrossRefPubMed
9.
go back to reference Chun FK, Graefen M, Zacharias M et al (2005) Anatomic radical retropubic prostatectomy long-term recurrence-free survival rates for localized prostate cancer. World J Urol 24:273–280CrossRef Chun FK, Graefen M, Zacharias M et al (2005) Anatomic radical retropubic prostatectomy long-term recurrence-free survival rates for localized prostate cancer. World J Urol 24:273–280CrossRef
10.
go back to reference Han M, Partin AW, Pound CR, Epstein JI, Walsh PC (2001) Long-term biochemical disease free and cancer-specific survival following anatomic radical retropubic prostatectomy: the 15-year Johns Hopkins experience. Urol Clin North Am 28:555–565CrossRefPubMed Han M, Partin AW, Pound CR, Epstein JI, Walsh PC (2001) Long-term biochemical disease free and cancer-specific survival following anatomic radical retropubic prostatectomy: the 15-year Johns Hopkins experience. Urol Clin North Am 28:555–565CrossRefPubMed
11.
go back to reference Bianco FJ Jr, Scardino PT, Eastham JA (2005) Radical prostatectomy: long term cancer control and recovery of sexual and urinary function (“trifecta”). Urology 66:83–94CrossRefPubMed Bianco FJ Jr, Scardino PT, Eastham JA (2005) Radical prostatectomy: long term cancer control and recovery of sexual and urinary function (“trifecta”). Urology 66:83–94CrossRefPubMed
12.
go back to reference Trabulsi EJ, Valicenti RK, Hanlon AL et al (2008) A multi-institutional matched-control analysis of adjuvant and salvage postoperative radiation therapy for pT3-4N0 prostate cancer. Urology 72:1298–1302PubMedCentralCrossRefPubMed Trabulsi EJ, Valicenti RK, Hanlon AL et al (2008) A multi-institutional matched-control analysis of adjuvant and salvage postoperative radiation therapy for pT3-4N0 prostate cancer. Urology 72:1298–1302PubMedCentralCrossRefPubMed
13.
go back to reference Geinitz H, Riegel MG, Thamm R et al (2012) Outcome after conformal salvage radiotherapy in patients with rising prostate specific antigen levels after radical prostatectomy. Int J Radiat Oncol Biol Phys 82:1930–1937CrossRefPubMed Geinitz H, Riegel MG, Thamm R et al (2012) Outcome after conformal salvage radiotherapy in patients with rising prostate specific antigen levels after radical prostatectomy. Int J Radiat Oncol Biol Phys 82:1930–1937CrossRefPubMed
14.
go back to reference Smith DP, King MT, Egger S et al (2009) Quality of life three years after diagnosis of localized prostate cancer: population based cohort study. BMJ 339:b4817PubMedCentralCrossRefPubMed Smith DP, King MT, Egger S et al (2009) Quality of life three years after diagnosis of localized prostate cancer: population based cohort study. BMJ 339:b4817PubMedCentralCrossRefPubMed
15.
go back to reference Tsujimura A (2013) Role of androgen in the elderly. Problems of androgen deprivation therapy. Clin Calcium 23(8):1185–1190PubMed Tsujimura A (2013) Role of androgen in the elderly. Problems of androgen deprivation therapy. Clin Calcium 23(8):1185–1190PubMed
16.
go back to reference Hamberg P, Verhagen PC, de Wit R (2008) When to start cytotoxic therapy in asymptomatic patients with hormone refractory prostate cancer? Eur J Cancer 44:1193–1197CrossRefPubMed Hamberg P, Verhagen PC, de Wit R (2008) When to start cytotoxic therapy in asymptomatic patients with hormone refractory prostate cancer? Eur J Cancer 44:1193–1197CrossRefPubMed
17.
go back to reference Chambers AF, Groom AC, MacDonald IC (2002) Dissemination and growth of cancer cells in metastatic sites. Nat Rev Cancer 2(8):563–572CrossRefPubMed Chambers AF, Groom AC, MacDonald IC (2002) Dissemination and growth of cancer cells in metastatic sites. Nat Rev Cancer 2(8):563–572CrossRefPubMed
18.
go back to reference Kal HB, Van Gellekom MP (2003) How low is the alpha/beta ratio for prostate cancer? Int J Radiat Oncol Biol Phys 57:1116–1121CrossRefPubMed Kal HB, Van Gellekom MP (2003) How low is the alpha/beta ratio for prostate cancer? Int J Radiat Oncol Biol Phys 57:1116–1121CrossRefPubMed
19.
go back to reference Wang JZ, Li XA, Yu CX, DiBiase SJ (2003) The low alpha/beta ratio for prostate cancer: what does the clinical outcome of HDR brachytherapy tell us? Int J Radiat Oncol Biol Phys 57:1101–1108CrossRefPubMed Wang JZ, Li XA, Yu CX, DiBiase SJ (2003) The low alpha/beta ratio for prostate cancer: what does the clinical outcome of HDR brachytherapy tell us? Int J Radiat Oncol Biol Phys 57:1101–1108CrossRefPubMed
20.
go back to reference Jereczec-Fossa BA, Beltramo G, Fariselli L et al (2012) Robotic image-guided stereotactic radiotherapy for isolated recurrent primary, lymph node or metastatic prostate cancer. Int J Radiat Oncol Biol Phys 82(2):889–897 Jereczec-Fossa BA, Beltramo G, Fariselli L et al (2012) Robotic image-guided stereotactic radiotherapy for isolated recurrent primary, lymph node or metastatic prostate cancer. Int J Radiat Oncol Biol Phys 82(2):889–897
21.
go back to reference Catton C, Gospodarowicz M, Warde P et al (2001) Adjuvant and salvage radiation therapy after radical prostatectomy for adenocarcinoma of the prostate. Radiother Oncol 59:51–60CrossRefPubMed Catton C, Gospodarowicz M, Warde P et al (2001) Adjuvant and salvage radiation therapy after radical prostatectomy for adenocarcinoma of the prostate. Radiother Oncol 59:51–60CrossRefPubMed
22.
go back to reference Stephenson AJ, Shariat S, Zelefsky M et al (2004) Salvage radiotherapy for recurrent prostate cancer after radical prostatectomy. JAMA 291:1325–1332CrossRefPubMed Stephenson AJ, Shariat S, Zelefsky M et al (2004) Salvage radiotherapy for recurrent prostate cancer after radical prostatectomy. JAMA 291:1325–1332CrossRefPubMed
23.
go back to reference Strom TJ, Wilder RB, Fernandez DC, Mellon EA, Saini AS, Hunt DC, Biagioli MC (2014) High-dose-rate brachytherapy with or without intensity modulated radiation therapy as salvage treatment for an isolated, gross local recurrence of prostate cancer post-prostatectomy. Brachytherapy 13(2):123–127 Strom TJ, Wilder RB, Fernandez DC, Mellon EA, Saini AS, Hunt DC, Biagioli MC (2014) High-dose-rate brachytherapy with or without intensity modulated radiation therapy as salvage treatment for an isolated, gross local recurrence of prostate cancer post-prostatectomy. Brachytherapy 13(2):123–127
24.
go back to reference Gomez-Veiga F, Mariño A, Alvarez L, Rodriguez I, Fernandez C, Pertega S, Candal A (2012) Brachytherapy for the treatment of recurrent prostate cancer after radiotherapy or radical prostatectomy. BJU Int 109(Suppl 1):17–21CrossRefPubMed Gomez-Veiga F, Mariño A, Alvarez L, Rodriguez I, Fernandez C, Pertega S, Candal A (2012) Brachytherapy for the treatment of recurrent prostate cancer after radiotherapy or radical prostatectomy. BJU Int 109(Suppl 1):17–21CrossRefPubMed
25.
go back to reference Jung C, Cookson MS, Chang SS, Smith JA Jr, Dietrich MS, Teng M (2007) Toxicity following high-dose salvage radiotherapy after radical prostatectomy. BJU Int 99(3):529–533CrossRefPubMed Jung C, Cookson MS, Chang SS, Smith JA Jr, Dietrich MS, Teng M (2007) Toxicity following high-dose salvage radiotherapy after radical prostatectomy. BJU Int 99(3):529–533CrossRefPubMed
Metadata
Title
CyberKnife stereotactic radiotherapy for isolated recurrence in the prostatic bed
Authors
B. Detti
P. Bonomo
L. Masi
R. Doro
S. Cipressi
C. Iermano
I. Bonucci
D. Franceschini
L. Di Brina
M. Baki
G. Simontacchi
I. Meattini
M. Carini
S. Serni
G. Nicita
L. Livi
Publication date
01-03-2016
Publisher
Springer Berlin Heidelberg
Published in
World Journal of Urology / Issue 3/2016
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI
https://doi.org/10.1007/s00345-015-1613-5

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