To assess outcomes between salvage radiation therapy (SRT) with curative intent and stereotactic radiotherapy for macroscopic prostate recurrence (SSRT) after radical prostatectomy (RP). In order to compare these two different options, we compared their outcomes with a propensity score-based matched analysis.
Data from 185 patients in seven Italian centres treated for macroscopic prostate bed recurrence after RP were retrospectively collected. To make a comparison between the two treatment groups, propensity matching was applied to create comparable cohorts.
After matching, 90 patients in the SRT and SSRT groups were selected (45 in each arm). Kaplan-Meier analysis did not show any significant differences in terms of BRFS and PFS between matched populations (p = 0.08 and p = 0.8, respectively). Multivariate models show that treatment was not associated with BRFS, neither in the whole or matched cohort, with HR of 2.15 (95%CI 0.63-7.25, p = 0.21) and 2.65 (95%CI 0.59-11.97, p = 0.21), respectively. In the matched cohort, lower rate of toxicity was confirmed for patients undergoing SSRT, with acute GI and GU adverse events reported in 4.4 versus 44.4% (p < 0.001) and 28.9 versus 46.7% (p = 0.08) of patients, and late GI and GU adverse events reported in 0 versus 13.3% (p = 0.04) and 6.7 versus 22.2% (p = 0.03) of patients, respectively.
Considering the favourable therapeutic ratio of this approach and the lower number of fractions needed, SSRT should be considered as an attractive alternative to conventional SRT in this setting.
La Radiologia medica. 2022 Mar 05 [Epub ahead of print]
Giulio Francolini, Barbara Alicja Jereczek-Fossa, Vanessa Di Cataldo, Gabriele Simontacchi, Giulia Marvaso, Sara Gandini, Federica Corso, Lucia Pia Ciccone, Maria Alessia Zerella, Piercarlo Gentile, Federico Bianciardi, Sara Allegretta, Beatrice Detti, Isacco Desideri, Rolando Maria D'Angelillo, Laura Masi, Gianluca Ingrosso, Mario Di Staso, Ercole Mazzeo, Fabio Trippa, Frank Lohr, Alessio Bruni, Lorenzo Livi
Radiation Oncology Unit, Azienda Ospedaliero-Universitaria Careggi, Viale Morgagni 85, 50134, Florence, Italy. ., Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy., Radiation Oncology Unit, Azienda Ospedaliero-Universitaria Careggi, Viale Morgagni 85, 50134, Florence, Italy., Department of Experimental Oncology, European Institute of Oncology IRCCS, Via Adamello 16, 20139, Milan, Italy., Department of Biomedical, Experimental, and Clinical Sciences "Mario Serio", University of Florence, Florence, Italy., UPMC San Pietro FBF, Rome, Italy., Department of Radiation Oncology, Policlinico Tor Vergata University, Viale Oxford 81, 00133, Rome, RM, Italy., Department of Medical Physics and Radiation Oncology, IFCA, 50139, Florence, Italy., Radiation Oncology Section, Department of Medicine and Surgery, Perugia General Hospital, University of Perugia, Perugia, Italy., Radiotherapy Unit, "Nuovo San Salvatore" Hospital, L'Aquila, Italy., Radiotherapy Unit, University Hospital of Modena, Modena, Italy., Radiotherapy Oncology Centre, Azienda Ospedaliera S. Maria, Terni, Italy.
PubMed http://www.ncbi.nlm.nih.gov/pubmed/35247134