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Pattern of Recurrence After Stereotactic Radiotherapy in Prostate Cancer Patients With Nodal Pelvic Relapse. A
G Francolini1, C Bellini2, V Di Cataldo3
1Radiotherapy Unit, Azienda Ospedaliera Universitaria Careggi, Firenze, Italy.
Clinical Oncology (Royal College of Radiologists (Great Britain))
|October 2, 2021
Summary
Nodal stereotactic body radiotherapy (SBRT) shows promise for pelvic oligorecurrent disease after prostatectomy. This treatment offers encouraging disease-free survival and androgen deprivation therapy-free survival, with many patients eligible for repeat SBRT if needed.
Area of Science:
- Oncology
- Radiation Oncology
- Urologic Oncology
Background:
- Nodal pelvic oligorecurrent disease after radical prostatectomy lacks standard salvage treatment.
- Stereotactic body radiotherapy (SBRT) is an emerging option for such cases.
- This study investigates recurrence patterns and survival after nodal SBRT.
Purpose of the Study:
- To analyze recurrence patterns following nodal SBRT in patients with pelvic oligometastatic relapse post-prostatectomy.
- To evaluate androgen deprivation therapy (ADT)-free survival in this patient cohort.
Main Methods:
- Retrospective review of 93 patients treated across five institutions.
- Inclusion criteria: biochemical recurrence post-prostatectomy, ≤3 lymph node metastases below aortic bifurcation.
- All sites of disease treated with SBRT; concomitant ADT was permitted.
Main Results:
- Median follow-up of 20 months; median disease-free survival (DFS) of 15 months.
- Relapse patterns: 8.6% prostate bed, 22.6% pelvic nodal, 30.1% distant.
- Median ADT-free survival not reached; 45.2% received a second SBRT course.
Conclusions:
- Nodal SBRT demonstrates encouraging DFS and ADT-free survival for pelvic oligorecurrence.
- Prostate bed recurrence was infrequent, suggesting local treatment may be avoidable.
- A significant proportion of patients can be retreated with a second SBRT course.
