Salvage External Beam Radiotherapy for Recurrent Prostate Adenocarcinoma after High-Intensity Focused Ultrasound as Primary Treatment

被引:10
作者
Munoz, Fernando [1 ]
Guarneri, Alessia [1 ]
Botticella, Angela [1 ]
Gabriele, Pietro [2 ]
Moretto, Francesco [1 ]
Panaia, Rocco [2 ]
Ruggieri, Andrea [1 ]
D'Urso, Leonardo [3 ]
Muto, Giovanni [3 ]
Filippi, Andrea Riccardo [1 ]
Ragona, Riccardo [1 ]
Ricardi, Umberto [1 ]
机构
[1] Univ Turin, Dept Oncol, Radiat Oncol Unit, IT-10126 Turin, Italy
[2] Inst Canc Res & Treatment, Dept Radiat Oncol, Candiolo, Italy
[3] San Giovanni Bosco Hosp, Dept Urol, Turin, Italy
关键词
High-intensity focused ultrasound relapse; Nadir prostate-specific antigen; Recurrent prostate adenocarcinoma; Salvage external beam radiotherapy; Toxicity; MODULATED RADIOTHERAPY; RADICAL PROSTATECTOMY; PSA NADIR; CANCER; EXPERIENCE; THERAPY; FAILURE;
D O I
10.1159/000345631
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Introduction: The main objective was to evaluate feasibility, toxicity and biochemical control rates of salvage external beam radiotherapy (EBRT) in recurrent localized prostate cancer after high-intensity focused ultrasound (HIFU) as primary therapy. Patients and Methods: A total of 24 patients who underwent salvage EBRT after 1 or 2 HIFU sessions and with a minimum post-treatment follow-up of 24 months were retrospectively evaluated. Primary endpoints were toxicity and biochemical disease-free survival (bDFS, defined according to the ASTRO Phoenix definition). Results: Median follow-up was 40.3 months. Gastrointestinal toxicity was low. Acute genitourinary (GU) toxicity grade <= II rate was 45.8%, with only few patients presenting grade III (8.3%) and grade IV (4.2%) toxicity. Late grade >= III GU toxicity was registered in 16.7% of patients. The 3-year bDFS rate was 77.8%. Patients achieving a nadir prostate-specific antigen (nPSA) of <= 0.35 ng/ml after EBRT had significantly higher bDFS (3-year bDFS: 87.7 vs. 50%, respectively; p = 0.001). Achieving nPSA <= 0.35 ng/ml was the only factor independently associated to long-term bDFS both on univariate (p = 0.01) and multivariate analysis (HR 7.06, p = 0.039). Conclusions: Salvage EBRT after HIFU failure is feasible and allows to obtain satisfactory biochemical control rates, especially in patients attaining a nPSA <= 0.35 ng/ml after EBRT. Copyright (C) 2013 S. Karger AG, Basel
引用
收藏
页码:288 / 293
页数:6
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