Session Item

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

Between October 2012 and June 2022, 21 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 ReS-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 68 years (range 59-79). 45% (9/20) were low risk, 30% (6/20) intermediate risk, 10% (2/20) high risk and 15% (3/20) not specified. Median follow-up was 24 months (range 1-101,9m). Patients were treated in IMRT Vs VMAT (15/5).  All patients received 60 Gy (2.5 Gy/fraction) to the prostate and 30% (6/20) 55.2Gy (2,3 Gy/fraction) to the seminal vesicles. Furthermore, 40% (8/20) 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 0,14ng/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): 25% (5/20) patients had acute urinary toxicities Grade > 3. In addition, Rectitis Grade > 2 were observed in 10% (2/20); 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 Reirradiation 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.