Salvage Re-Irradiation After Locoregional Failure with Primary Radiotherapy for Prostate Cancer

2020 ◽  
pp. 143-149
Author(s):  
Sanchia S. Goonewardene ◽  
Raj Persad ◽  
David Albala ◽  
Declan Cahill
Keyword(s):  
Prostate Cancer ◽  
Locoregional Failure ◽  
Primary Radiotherapy

scholarly journals Image Guided Hypofractionated Radiotherapy by Helical Tomotherapy for Prostate Carcinoma: Toxicity and Impact on Nadir PSA

2014 ◽  
Vol 2014 ◽  
pp. 1-9 ◽  
Author(s):  
Salvina Barra ◽  
Stefano Vagge ◽  
Michela Marcenaro ◽  
Gladys Blandino ◽  
Giorgia Timon ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Helical Tomotherapy ◽  
Late Toxicity ◽  
Conformal Radiotherapy ◽  
Conventional Fractionation ◽  
Gu Toxicity ◽  
Gi Toxicity ◽  
Low Toxicity ◽  
Primary Radiotherapy

Aim. To evaluate the toxicity of a hypofractionated schedule for primary radiotherapy (RT) of prostate cancer as well as the value of the nadir PSA (nPSA) and time to nadir PSA (tnPSA) as surrogate efficacy of treatment.Material and Methods. Eighty patients underwent hypofractionated schedule by Helical Tomotherapy (HT). A dose of 70.2 Gy was administered in 27 daily fractions of 2.6 Gy. Acute and late toxicities were graded on the RTOG/EORTC scales. The nPSA and the tnPSA for patients treated with exclusive RT were compared to an equal cohort of 20 patients treated with conventional fractionation and standard conformal radiotherapy.Results. Most of patients (83%) did not develop acute gastrointestinal (GI) toxicity and 50% did not present genitourinary (GU) toxicity. After a median follow-up of 36 months only grade 1 of GU and GI was reported in 6 and 3 patients as late toxicity. Average tnPSA was 30 months. The median value of nPSA after exclusive RT with HT was 0.28 ng/mL and was significantly lower than the median nPSA (0.67 ng/mL) of the conventionally treated cohort (P=0.02).Conclusions. Hypofractionated RT schedule with HT for prostate cancer treatment reports very low toxicity and reaches a low level of nPSA that might correlate with good outcomes.

scholarly journals 68 Ga‐PSMA‐PET/CT helps to select patients for salvage radical prostatectomy with local recurrence after primary radiotherapy for prostate cancer

2020 ◽  
Vol 126 (6) ◽  
pp. 679-683
Author(s):  
David Pfister ◽  
Friederike Haidl ◽  
Tim Nestler ◽  
Frederik Verburg ◽  
Matthias Schmidt ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Local Recurrence ◽  
Psma Pet ◽  
Pet Ct ◽  
Primary Radiotherapy ◽  
Salvage Radical Prostatectomy

OC-0072: Focal salvage Iodine-125 brachytherapy for recurrent prostate cancer after primary radiotherapy

2014 ◽  
Vol 111 ◽  
pp. S27
Author(s):  
M. Peters ◽  
M. Maenhout ◽  
J.R.N. Van der Voort van Zyp ◽  
M.A. Moerland ◽  
M. Moman ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Recurrent Prostate Cancer ◽  
Primary Radiotherapy ◽  
Iodine 125

scholarly journals Patient Reported Urinary Incontinence and Sexual Impotency Following Multimodality Radical Therapy for Prostate Cancer: An Untold Story of Compound Toxicity?

2021 ◽  
Author(s):  
Ori Haisraely ◽  
Yaacov Richard Lawrence ◽  
Ron Lewin ◽  
Orit Kaidar-Person ◽  
Ilana Weiss ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Urinary Incontinence ◽  
Odds Ratio ◽  
Smoking Status ◽  
Urinary Continence ◽  
Sexual Performance ◽  
Cross Sectional ◽  
Significant Difference ◽  
Patient Reported ◽  
Primary Radiotherapy

Abstract Purpose: To evaluate urinary continence and sexual potency following radical prostatectomy and adjuvant radiotherapy. Materials/Methods: Expanded Prostate Cancer Index Composite (EPIC) surveys of patients with localized prostate cancer treated with surgery followed by adjuvant/salvage pelvic radiotherapy (S+RT) were analyzed. A control cohort was primary radiotherapy (RT). Results: Surveys at least 1 year after treatment were available for 130 S+RT and 374 RT patients. For S+RT vs. RT, the mean urinary incontinence score was 68 [6.25 -100] versus 86.4 [CI-95 39.5-100] (p<0.001), confirming 6.5 points of clinically significant difference. The adjusted odds ratio for superior urinary function was 2.67 (1.7-4.1, p<0.001) for primary radiotherapy. The odds ratio of having both poor urinary and sexual performance was 0.29 in RT arm (0.14-0.58, p<0.001) when adjusted to age and ADT use, group risk stratification, co morbidities and smoking status. Conclusion: In this cross sectional study, Surgery with adjuvant/salvage RT was associated with significantly worse patient reported urinary continence outcomes at 1-year post treatment, lower odds of achieving perfect urinary continence and a threefold risk of reverse ‘bifecta’ with inferior urinary continence and sexual performance. Longitudinal studies of evolving toxicity are required to validate these findings.

scholarly journals Patient Reported Urinary Incontinence and Sexual Impotency Following Multimodality Radical Therapy for Prostate Cancer: An Untold Story of Compound Toxicity?

2021 ◽  
Author(s):  
Ori Haisraely ◽  
Yaacov Richard Lawrence ◽  
Ron Lewin ◽  
Orit Kaidar-Person ◽  
Ilana Weiss ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Urinary Incontinence ◽  
Odds Ratio ◽  
Smoking Status ◽  
Urinary Continence ◽  
Sexual Performance ◽  
Urinary Function ◽  
Significant Difference ◽  
Patient Reported ◽  
Primary Radiotherapy

Abstract Purpose: To evaluate urinary continence and sexual potency following radical prostatectomy and adjuvant radiotherapy.Materials/Methods: Expanded Prostate Cancer Index Composite (EPIC) surveys of patients with localized prostate cancer treated with surgery followed by adjuvant/salvage pelvic radiotherapy (S+RT) were analyzed. A control cohort was primary radiotherapy (RT). Reverse "bifecta" was defined as a score less than 60 in both incontinence and sexual domains. Superior urinary function was defined as a score above 90. The clinically important difference was calculated using a distribution approach.Results: Surveys at least 1 year after treatment were available for 130 S+RT and 374 RT patients. For S+RT vs. RT, the mean urinary incontinence score was 68 [6.25 -100] versus 86.4 [CI-95 39.5-100] (p<0.001), confirming 6.5 points of clinically significant difference. The adjusted odds ratio for superior urinary function was 2.67 (1.7-4.1, p<0.001) for primary radiotherapy. The odds ratio of having both poor urinary and sexual performance (reverse " bifecta") was 0.29 in RT arm (0.14-0.58, p<0.001) when adjusted for age and Androgen Deprivation Therapy (ADT) , group risk stratification, comorbidities and smoking status.Conclusion: In this cross sectional study, Surgery with adjuvant/salvage RT was associated with significantly worse patient reported urinary continence outcomes at 1-year post treatment, lower odds of achieving perfect urinary continence and a threefold risk of reverse ‘bifecta’ with inferior urinary continence and sexual performance. Longitudinal studies of evolving toxicity are required to validate these findings. Patients referred for surgery with a high probability of requiring adjuvant or salvage radiotherapy should be informed regarding the potential composite toxicity of both surgery and radiotherapy.

Health-Related Quality-of-Life Effects of Radical Prostatectomy and Primary Radiotherapy for Screen-Detected or Clinically Diagnosed Localized Prostate Cancer

2001 ◽  
Vol 19 (6) ◽  
pp. 1619-1628 ◽  
Author(s):  
Joanna B. Madalinska ◽  
Marie-Louise Essink-Bot ◽  
Harry J. de Koning ◽  
Wim J. Kirkels ◽  
Paul J. van der Maas ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Localized Prostate Cancer ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related ◽  
Primary Radiotherapy ◽  
Prospective Longitudinal

PURPOSE: The current study was undertaken within the framework of a screening trial to compare the health-related quality-of-life (HRQOL) outcomes of two primary treatment modalities for localized prostate cancer: radical prostatectomy and external-beam radiotherapy. PATIENTS AND METHODS: We conducted a prospective longitudinal cohort study among 278 patients with early screen-detected (59%) or clinically diagnosed (41%) prostate cancer using both generic and disease-specific HRQOL measures (SF-36, UCLA Prostate Cancer Index [urinary and bowel modules] and items relating to sexual functioning) at three points in time: t1 (baseline), t2 (6 months later), and t3 (12 months after t1). RESULTS: Questionnaires were completed by 88% to 93% of all initially enrolled patients. Patients referred for primary radiotherapy were significantly older than prostatectomy patients (63 v 68 years, P < .01). Analyses (adjusted for age and pretreatment level of functioning) revealed poorer levels of generic HRQOL after radiotherapy. Prostatectomy patients reported significantly higher (P < .01) posttreatment incidences of urinary incontinence (39% to 49%) and erectile dysfunction (80% to 91%) than radiotherapy patients (respectively, 6% to 7% and 41% to 55%). Bowel problems (urgency) affected 30% to 35% of the radiotherapy group versus 6% to 7% of the prostatectomy group (P < .01). Patients with screen-detected and clinically diagnosed cancer reported similar posttreatment HRQOL. CONCLUSION: Prostatectomy and radiotherapy differed in the type of HRQOL impairment. Because the HRQOL effects may be valued differently at the individual level, patients should be made fully aware of the potential benefits and adverse consequences of therapies for early prostate cancer. Differences in posttreatment HRQOL were not related to the method of cancer detection.

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