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Patterns of recurrence after prostate bed radiotherapy.

Douglas H Brand1, Joanna I Parker2, David P Dearnaley1

  • 1Urological Oncology Department, Royal Marsden Hospital, London & Sutton, UK; Radiotherapy and Imaging Division, Institute of Cancer Research, London & Sutton, UK.

Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology
|September 30, 2019
PubMed
Summary

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Chronic obstructive pulmonary disease: diagnosis, monitoring and chronic management in nursing practice.

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Dose dE-eScalaTion IN prostATe radIOtherapy usiNg an MR-Linac in 2 Fractions (DESTINATION 2): protocol for a randomised, phase II/R-IDEAL2b trial.

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Reply to Therese Kang and Wee Loon Ong's Letter to the Editor re: Ragu Ratnakumaran, Douglas H. Brand, Archana Sasitharan, et al. Exploring Factors Associated with Late Urinary Toxicity After Prostate Stereotactic Body Radiotherapy: Findings from the PACE-B Study. Eur Urol 2026;89:71-9.

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Hydraulic endorectal actuator for prostate radiotherapy reduces variations in motion in a silicone rectal phantom.

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PACE-NODES: A phase III randomised trial of 5 fraction prostate stereotactic body radiotherapy (SBRT) versus 5 fraction prostate and pelvic nodal SBRT.

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Correlation of Biochemical Recurrence With Adverse Late Toxic Events Following Prostate Radiation Therapy (COBALT Study): An Individual Patient Data Meta-Analysis of 7 Randomized Trials.

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Pelvic lymph node failure is common after prostate bed radiotherapy, even with low PSA levels. Including pelvic lymph nodes in treatment may improve outcomes for patients post-prostatectomy.

Area of Science:

  • Oncology
  • Radiation Oncology
  • Urologic Oncology

Background:

  • Prostate bed radiotherapy is a standard treatment following radical prostatectomy.
  • Recent evidence suggests including pelvic lymph nodes in the radiotherapy volume for patients with PSA > 0.34 ng/ml.
  • Patterns of failure after prostate bed radiotherapy require further investigation.

Purpose of the Study:

  • To describe patterns of failure after prostate bed radiotherapy.
  • To determine the proportion of patients with isolated pelvic nodal failure.
  • To evaluate the significance of pelvic lymph node inclusion in radiotherapy treatment volumes.

Main Methods:

  • Retrospective analysis of 322 patients receiving prostate bed radiotherapy (1997-2013).
  • Key outcome: pattern of radiologic failure.
Keywords:
Prostate cancerRecurrent prostate cancerSalvage radiotherapy

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  • Comparison of baseline characteristics for isolated pelvic nodal failure versus other relapse patterns using Chi-square test (p < 0.005).

    • Main Results:

    • Biochemical failure occurred in 140 patients; radiologic failure in 89.
    • 39% (35/89) of radiologic failures were isolated pelvic nodal disease.
    • Pelvic nodal failure rates were similar for PSA < 0.34 ng/ml and PSA > 0.34 ng/ml.

    Conclusions:

    • Isolated pelvic lymph node disease is a frequent failure site after prostate bed radiotherapy.
    • This finding supports the inclusion of pelvic lymph nodes in the radiotherapy treatment volume.
    • The study highlights the need to consider pelvic nodal irradiation regardless of baseline PSA levels.