Re-irradiation in patients affected by prostate cancer and relapsing after previous definitive or postoperative radiotherapy. An international registry based study on behalf of Italian association of radiotherapy and clinical oncology (AIRO). (RE-START).
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Francolini Giulio, Cataldo Vanessa Di, Caini Saverio, Jereczek-Fossa Barbara A, Marvaso Giulia, Mastroleo Federico, Cammareri Eugenio, Alterio Daniela, Miszczyk Marcin, Majewski Wojciech, Hasterok Maja, Matrone Fabio, Donofrio Alessandra, Triggiani Luca, Morelli Vittorio, Belgioia Liliana, D'angelo Elisa, Mazzola Rosario, Ingargiola Rossana, Fontana Antonella, Cacciola Alberto, Scipilliti Esmeralda, Bardoscia Lilia, Ciccarelli Stefano, Allegra Andrea Gaetano, Alongi Filippo, Masi Laura, Doro Raffaela, Loi Mauro, Simontacchi Gabriele, Garlatti Pietro, Aquilano Michele, Bertini Niccolò, Valicenti Richard K, Livi Lorenzo
Аннотация
MATERIALS AND METHODS: RESTART is an observational longitudinal study including patients with biochemical relapse according to EAU criteria after a previous course of definitive or postoperative RT, and treated for a macroscopic recurrence within the prostate or prostate bed visualized on PET-CT or magnetic resonance imaging (MRI). Patients were treated with stereotactic body radiotherapy (SBRT) or brachytherapy (BT), with fraction doses of at least 5 Gy for EBRT, and no other restrictions regarding fractionation schedule or total dose. Exclusion criteria consisted of the presence of regional nodal disease or distant metastases, persisting severe toxicities from previous RT or follow-up shorter than 6 months.
RESULTS: Four hundred and thirty-three patients from 5 centers were included in the current analysis. Overall, 64.2 % and 90.3 % of patients did not report any acuteGU or GI toxicity. No treatment-related deaths were registered. LateG2 or G3 GU toxicity was reported in 16.2 and 4.8 % of patients, respectively. After a median follow-up of 54 months (95 % CI 26-78), 239 biochemical recurrences (55.2 %), 119 radiologically-confirmed regional or distant relapses (27.2 %), and 95 deaths (21.9 %) were recorded, respectively.
CONCLUSION: Results confirm the safety, feasibility, and efficacy of re-irradiation for prostate cancer, and provide insights about features associated with improved oncological outcomes after treatment.