Session Item

This retrospective study evaluated at the tolerability and outcomes of salvage external beam radiotherapy (S-EBRT) for locally recurrent prostate cancer (LRPC) after definitive prostate brachytherapy (BQ)

Between October 2012 and June 2021, 15 patients with locally recurrent prostate cancer after brachytherapy (BQ) with biopsy-proven local-only recurrence and uroflowmetry test measure QMax > 12 ml/s and IPSS < 12, were planned to receive Salvage-EBRT: 60Gy +/- 55,2Gy (24 fractions at 5/weeks) to the prostate and seminal vesicles respectively; VMAT/IMRT technology with daily IGRT, previously urinary catheterization throughout the all treatment; The target volume consisted of the CTVp: prostate and CTVv: seminal vesicles; PTVp: CTVp + 3-5mm and PTVv: CTVv + 3-5mm and finally, the organs at risk (OARs) were delimited Bladder, urethra, rectum, femoral-heads, penis bulb. We evaluated biochemical failure (BF) was definited as PSA < post-treatment nadir+2, overall survival (OS), and acute/late gastrointestinal-urinary toxicities (CTCAE v 4.03) weekly during radiotherapy treatment and monthly after completion of treatment.

The median age of 67 years (range 59-74). 47% (7/15) were low risk, 27% (4/15) intermediate risk, 6%(1/15) high risk and 20% (3/15) not specified. Median follow-up was 13 months (range 1-101,9m). Patients were treated in IMRT/VMAT (10/5).  All patients received 60Gy (2.5 Gy/fraction) to the prostate and 27% (4/15) 55.2Gy (2,3 Gy/fr) to the seminal vesicles. Furthermore, 33,3% (5/15) received androgen deprivation therapy (ADT) concurrent for a median 6 months, starting 2 months prior RT. All patients completed EBRT. No patient has presented BF since the end of treatment with a median PSA nadir 0,18ng/mL (0,01-0,40), in an unspecified nadir PSA patient due to short follow-up period. All patients are alive at the present time. 

And acute/late gastrointestinal-urinary toxicities (CTCAE v 4.03): 33,3% (5/15) patients had acute urinary toxicities Grade > 3. In addition, Rectitis Grade > 2 were observed in 13,3% (2/15); No acute grade 4/5 toxicities were noted. Chronic toxicity, no grade Grade > 3 toxicities were noted.

Our data suggest that the treatment of locally recurrent prostate cancer with salvage External Beam Radiotherapy could provide adequate disease control and result in a safe technique that provides the patient with an alternative in the natural history of their disease.