Perennec Tanguy, Vaugier Loig, Toledano Alain, Scher Nathaniel, Thomin Astrid, Pointreau Yoann, Janoray Guillaume, De Crevoisier Renaud, Supiot Stéphane
Department of Radiation Oncology, Institut de Cancérologie de l'Ouest, Boulevard J. Monod, 44800 St-Herblain, France.
Department of Radiation Oncology, Institut de Radiothérapie et Radiochirurgie Hartmann, 92300 Levallois, France.
Cancers (Basel). 2021 Aug 27;13(17):4339. doi: 10.3390/cancers13174339.
Prostate cancer recurrence in patients previously treated with radical prostatectomy and radiation therapy is challenging. Re-irradiation could be an option, but data regarding efficacy and safety are lacking. We retrospectively evaluated salvage re-irradiation for local recurrence after prostatectomy and external beam radiation therapy. We collected data from 48 patients who underwent salvage reirradiation with stereotactic radiation therapy for local prostate cancer recurrence in the prostatic bed at four French centers. Fifteen patients (31%) were on androgen deprivation therapy during stereotactic radiotherapy. Biochemical response and relapse-free survival were analyzed, and post-treatment toxicities were assessed according to the Common Terminology of Adverse Events criteria. Five patients had grade 3 late bladder toxicity (cystitis), three had grade 3 late incontinence, and one had grade 3 late chronic pain. At three months, 83% of patients had a positive biochemical response. The median follow-up was 22 months. At the end of the follow-up, 21 patients (43%) had a biochemical relapse. The median time to biologic relapse was 27 months. The biochemical relapse rates at 1 and 2 years were 80% and 52%, respectively. In conclusion, salvage re-irradiation for recurrent prostate cancer in the prostate bed may generate significant toxicity rates, and a prospective study with appropriate patient selection is needed to evaluate its effectiveness.
对于先前接受过根治性前列腺切除术和放射治疗的患者，前列腺癌复发是一项具有挑战性的问题。再次放疗可能是一种选择，但关于其疗效和安全性的数据尚缺。我们回顾性评估了前列腺切除术后和外照射放疗后局部复发的挽救性再次放疗。我们收集了来自法国四个中心的48例因前列腺床局部前列腺癌复发而接受立体定向放射治疗进行挽救性再次放疗患者的数据。15例患者（31%）在立体定向放疗期间接受雄激素剥夺治疗。分析了生化反应和无复发生存率，并根据不良事件通用术语标准评估了治疗后的毒性反应。5例患者出现3级晚期膀胱毒性（膀胱炎），3例出现3级晚期尿失禁，1例出现3级晚期慢性疼痛。三个月时，83%的患者生化反应呈阳性。中位随访时间为22个月。随访结束时，21例患者（43%）出现生化复发。生物复发的中位时间为27个月。1年和2年时的生化复发率分别为80%和52%。总之，对前列腺床复发性前列腺癌进行挽救性再次放疗可能会产生较高的毒性率，需要进行一项有适当患者选择的前瞻性研究来评估其有效性。
