Skip to main content
Top
Published in: Strahlentherapie und Onkologie 3/2024

Open Access 29-12-2023 | Radiotherapy | Original Article

Stereotactic body radiotherapy (SBRT) re-irradiation for local failures following radical prostatectomy and post-operative radiotherapy

Authors: Wojciech Majewski, MD, PhD, Marcin Miszczyk, Donata Graupner, Bartłomiej Goc, Gregor Goldner, Aleksandra Napieralska

Published in: Strahlentherapie und Onkologie | Issue 3/2024

Login to get access

Abstract

Purpose

Local recurrences after radical prostatectomy (RP) and postoperative radiotherapy (RT) are challenging for salvage treatment. Retrospective analysis of own experiences with salvage re-irradiation was performed.

Methods

The study included all consecutive patients treated with salvage stereotactic body radiotherapy (sSBRT) for prostate bed recurrence following RP and postoperative RT at a single tertiary center between 2014 and 2021. Treatment toxicity defined as the occurrence of CTCAE grade ≥ 2 genito-urinary (GU) or gastro-intestinal (GI) adverse events (AEs) was assessed. A PSA response, biochemical control (BC) and overall survival (OS) were also evaluated.

Results

The study group included 32 patients with a median age of 68 years and a median follow-up of 41 months, treated with CyberKnife (53%) or Linac (47%) sSBRT. Total dose of 33.75–36.25 Gy in five fractions (72%) was applied in the majority of them. Approximately 19% patients reported grade ≥ 2 GU AEs both at baseline and at three months, and grade ≥ 2 GI toxicity increased from 0% at baseline to 6% at three months after sSBRT. There was some clinically relevant increase in late toxicity with 31% patients reporting late ≥ 2 GU, and 12.5% late ≥ 2 GI AEs. Two grade 3 AEs were recorded: recto-urinary fistulas. The majority of patients showed a PSA response (91% at one year post-sSBRT). The 3‑year BC was 40% and 3‑year OS was 87%.

Conclusions

Manageable toxicity profile and satisfactory biochemical response suggest that SBRT in patients with local recurrence following RP and postoperative RT might be a salvage option for selected patients.
Appendix
Available only for authorised users
Literature
10.
go back to reference Miszczyk M, Kraszkiewicz M, Moll M et al (2023) Long-term outcome of stereotactic body radiotherapy (SBRT) for intraprostatic relapse after definitive radiotherapy for prostate cancer: patterns of failure and association between volume of irradiation and late toxicity. Cancers (basel) 15:1180. https://doi.org/10.3390/cancers15041180CrossRefPubMed Miszczyk M, Kraszkiewicz M, Moll M et al (2023) Long-term outcome of stereotactic body radiotherapy (SBRT) for intraprostatic relapse after definitive radiotherapy for prostate cancer: patterns of failure and association between volume of irradiation and late toxicity. Cancers (basel) 15:1180. https://​doi.​org/​10.​3390/​cancers15041180CrossRefPubMed
21.
go back to reference Francolini G, Loi M, Di Cataldo V, et al. (2022). Stereotactic re-irradiation in recurrent prostate cancer after previous postoperative or definitive radiotherapy: long-term results after a median follow-up of 4 years. Clin Oncol (R Coll Radiol) 34: 50–56. https://doi.org/10.1016/j.clon.2021.11.002 Francolini G, Loi M, Di Cataldo V, et al. (2022). Stereotactic re-irradiation in recurrent prostate cancer after previous postoperative or definitive radiotherapy: long-term results after a median follow-up of 4 years. Clin Oncol (R Coll Radiol) 34: 50–56. https://​doi.​org/​10.​1016/​j.​clon.​2021.​11.​002
Metadata
Title
Stereotactic body radiotherapy (SBRT) re-irradiation for local failures following radical prostatectomy and post-operative radiotherapy
Authors
Wojciech Majewski, MD, PhD
Marcin Miszczyk
Donata Graupner
Bartłomiej Goc
Gregor Goldner
Aleksandra Napieralska
Publication date
29-12-2023
Publisher
Springer Berlin Heidelberg
Published in
Strahlentherapie und Onkologie / Issue 3/2024
Print ISSN: 0179-7158
Electronic ISSN: 1439-099X
DOI
https://doi.org/10.1007/s00066-023-02187-2

Other articles of this Issue 3/2024

Strahlentherapie und Onkologie 3/2024 Go to the issue