Second-Line Radiation Therapy for Locally Recurrent Prostate Cancer After Focal Therapy: A Single Institution...

Area of Science:

• Oncology
• Radiation Oncology
• Urology

Background:

• Focal therapy (FT) offers targeted treatment for localized prostate cancer.
• Second-line radiation therapy (SRT) is considered after FT failure, but safety data is limited.
• This study evaluates toxicity outcomes of SRT following FT.

Purpose of the Study:

• To compare toxicity outcomes between patients receiving second-line radiation therapy (SRT) after focal therapy (FT) and patients treated with radiation therapy (RT) alone.
• To assess the safety and acceptability of SRT as a salvage treatment for prostate cancer.

Main Methods:

• Retrospective analysis of 5606 prostate cancer patients (2000-2024).
• Comparison of toxicities between 38 SRT patients and 76 propensity score-matched RT-alone patients.
• Analysis of acute and late gastrointestinal (GI) and genitourinary (GU) toxicities.

Main Results:

• No significant differences in acute or late grade ≥ 2 GI or GU toxicities between SRT and RT-alone groups.
• Acute grade ≥ 2 GU toxicity: 47% (SRT) vs. 32% (RT-alone); Acute grade ≥ 2 GI toxicity: 10.5% (SRT) vs. 8% (RT-alone).
• Comparable progression-free survival, prostate cancer-specific survival, and local recurrence rates between cohorts.

Conclusions:

• Second-line radiation therapy (SRT) after focal therapy (FT) demonstrates comparable acute and late toxicity profiles to radiation therapy (RT) alone.
• SRT is a safe and acceptable treatment option for patients with recurrent prostate cancer after initial FT failure.
• Findings support the use of SRT in managing prostate cancer recurrence post-FT.