Clinical Outcome of Salvage Radiotherapy for Locoregional Clinical Recurrence After Radical Prostatectomy

Objectives: To assess the clinical outcomes of prostate cancer patients treated with salvage radiotherapy (SRT) for locoregional clinical recurrence (CR) after radical prostatectomy (RP). Methods: Records of 60 patients with macroscopic locoregional recurrence after prostatectomy and referrals for S...

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Autores principales:	Sung Uk Lee MD, Kwan Ho Cho MD, Jin Ho Kim MD, Young Seok Kim MD, Taek-Keun Nam MD, Jae-Sung Kim MD, Jaeho Cho MD, Seo Hee Choi MD, Su Jung Shim MD, Jin Hee Kim MD, Ah Ram Chang MD
Formato:	article
Lenguaje:	EN
Publicado:	SAGE Publishing 2021
Materias:	Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/802cb9337c2c4010bb15c0453bb9e04e
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spelling	oai:doaj.org-article:802cb9337c2c4010bb15c0453bb9e04e2021-11-21T02:04:41ZClinical Outcome of Salvage Radiotherapy for Locoregional Clinical Recurrence After Radical Prostatectomy1533-033810.1177/15330338211041212https://doaj.org/article/802cb9337c2c4010bb15c0453bb9e04e2021-11-01T00:00:00Zhttps://doi.org/10.1177/15330338211041212https://doaj.org/toc/1533-0338Objectives: To assess the clinical outcomes of prostate cancer patients treated with salvage radiotherapy (SRT) for locoregional clinical recurrence (CR) after radical prostatectomy (RP). Methods: Records of 60 patients with macroscopic locoregional recurrence after prostatectomy and referrals for SRT were retrospectively investigated in the multi-institutional database. The median radiation dose was 70.2 Gy. Biochemical failure was defined as the prostate-specific antigen (PSA) ≥ nadir + 2 or initiation of androgen deprivation therapy (ADT) for increased PSA. Results: Median recurrent tumor size was 1.1 cm and pre-radiotherapy PSA level was 0.4 ng/ml. At a median follow-up of 83.1-month after SRT, 7-year biochemical failure-free survival (BCFFS), locoregional failure-free survival (LRFFS), distant metastasis-free survival (DMFS), and overall survival (OS) were 67.0%, 89.7%, 83.6%, and 91.2%, respectively. Higher Gleason's scores were associated with unfavorable BCFFS, DMFS, and OS. Pre-SRT PSA ≥0.5 ng/ml predicted worse BCFFS, LRFFS, and DMFS. In multivariate analyses, a Gleason's score of 8 to 10 was associated with decreased BCFFS (hazard ratio [HR] 3.12, 95% confidence interval [CI] 1.11-8.74, P = .031) and OS (HR 17.72, 95% CI 1.75-179.64, P = .015), and combined ADT decreased the risks of distant metastasis (HR 0.18, 95% CI 0.04-0.92, P = .039). Two patients (3.3%) experienced late grade 3 urinary toxicity. Conclusions: SRT for locoregional CR after RP achieved favorable outcomes with acceptable long-term toxicities. Higher Gleason's scores and pre-radiotherapy PSA level were unfavorable prognostic variables. Combined ADT may decrease the risks of metastases.Sung Uk Lee MDKwan Ho Cho MDJin Ho Kim MDYoung Seok Kim MDTaek-Keun Nam MDJae-Sung Kim MDJaeho Cho MDSeo Hee Choi MDSu Jung Shim MDJin Hee Kim MDAh Ram Chang MDSAGE PublishingarticleNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENTechnology in Cancer Research & Treatment, Vol 20 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Sung Uk Lee MD Kwan Ho Cho MD Jin Ho Kim MD Young Seok Kim MD Taek-Keun Nam MD Jae-Sung Kim MD Jaeho Cho MD Seo Hee Choi MD Su Jung Shim MD Jin Hee Kim MD Ah Ram Chang MD Clinical Outcome of Salvage Radiotherapy for Locoregional Clinical Recurrence After Radical Prostatectomy
description	Objectives: To assess the clinical outcomes of prostate cancer patients treated with salvage radiotherapy (SRT) for locoregional clinical recurrence (CR) after radical prostatectomy (RP). Methods: Records of 60 patients with macroscopic locoregional recurrence after prostatectomy and referrals for SRT were retrospectively investigated in the multi-institutional database. The median radiation dose was 70.2 Gy. Biochemical failure was defined as the prostate-specific antigen (PSA) ≥ nadir + 2 or initiation of androgen deprivation therapy (ADT) for increased PSA. Results: Median recurrent tumor size was 1.1 cm and pre-radiotherapy PSA level was 0.4 ng/ml. At a median follow-up of 83.1-month after SRT, 7-year biochemical failure-free survival (BCFFS), locoregional failure-free survival (LRFFS), distant metastasis-free survival (DMFS), and overall survival (OS) were 67.0%, 89.7%, 83.6%, and 91.2%, respectively. Higher Gleason's scores were associated with unfavorable BCFFS, DMFS, and OS. Pre-SRT PSA ≥0.5 ng/ml predicted worse BCFFS, LRFFS, and DMFS. In multivariate analyses, a Gleason's score of 8 to 10 was associated with decreased BCFFS (hazard ratio [HR] 3.12, 95% confidence interval [CI] 1.11-8.74, P = .031) and OS (HR 17.72, 95% CI 1.75-179.64, P = .015), and combined ADT decreased the risks of distant metastasis (HR 0.18, 95% CI 0.04-0.92, P = .039). Two patients (3.3%) experienced late grade 3 urinary toxicity. Conclusions: SRT for locoregional CR after RP achieved favorable outcomes with acceptable long-term toxicities. Higher Gleason's scores and pre-radiotherapy PSA level were unfavorable prognostic variables. Combined ADT may decrease the risks of metastases.
format	article
author	Sung Uk Lee MD Kwan Ho Cho MD Jin Ho Kim MD Young Seok Kim MD Taek-Keun Nam MD Jae-Sung Kim MD Jaeho Cho MD Seo Hee Choi MD Su Jung Shim MD Jin Hee Kim MD Ah Ram Chang MD
author_facet	Sung Uk Lee MD Kwan Ho Cho MD Jin Ho Kim MD Young Seok Kim MD Taek-Keun Nam MD Jae-Sung Kim MD Jaeho Cho MD Seo Hee Choi MD Su Jung Shim MD Jin Hee Kim MD Ah Ram Chang MD
author_sort	Sung Uk Lee MD
title	Clinical Outcome of Salvage Radiotherapy for Locoregional Clinical Recurrence After Radical Prostatectomy
title_short	Clinical Outcome of Salvage Radiotherapy for Locoregional Clinical Recurrence After Radical Prostatectomy
title_full	Clinical Outcome of Salvage Radiotherapy for Locoregional Clinical Recurrence After Radical Prostatectomy
title_fullStr	Clinical Outcome of Salvage Radiotherapy for Locoregional Clinical Recurrence After Radical Prostatectomy
title_full_unstemmed	Clinical Outcome of Salvage Radiotherapy for Locoregional Clinical Recurrence After Radical Prostatectomy
title_sort	clinical outcome of salvage radiotherapy for locoregional clinical recurrence after radical prostatectomy
publisher	SAGE Publishing
publishDate	2021
url	https://doaj.org/article/802cb9337c2c4010bb15c0453bb9e04e
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Clinical Outcome of Salvage Radiotherapy for Locoregional Clinical Recurrence After Radical Prostatectomy

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