EP-1540: Radiation therapy for patients with paraaortic lymph nodes metastases of prostate cancer

15519 Background: Radical salvage prostatectomy (sRPE) represents one local secondary treatment option with curative intent in patients failing radiation therapy for localized PCA. C-PET/CT is an innovative imaging technique for the evaluation of PCA. It was the purpose of our study to assess the sensitivity of C-PET/CT to predict local intra- and extraglandular extent of PCA and the presence of lymph node involvement. Methods: 45 patients with biopsy-proven locally recurrent PCA scheduled for sRPE underwent preoperative C-PET/CT. All patients underwent retropubic sRPE with extended pelvic lymphadenectomy. The prostatectomy specimens were processed according to the Stanford protocol and pathohistological results were compared to C-PET/CT findings. Intraglandular location of cancer nodules = 5mm was correlated with PET/CT findings. Results: A total of 45 patients underwent sRPE; mean preop. serum PSA was 7.8 (2–24) ng/ml; mean biopsy Gleason score was 5.6 (4–9). A mean of 19 (10 - 32) lymph nodes were removed. Pathohistology showed stage pT1–2pN0 in 27 (60%), stage pT3a/b and pTxpN1 PCA in 9 (20%) and 9 (20%) of patients, respectively. Positive surgical margins were identified in 5 (11%) patients. C-PET/CT identified 1, 2, 3 or more than 3 intraprostatic cancer nodules in 23 (51.1%), 13 (28.9%) and 9 (20%) patients, respectively. Correlation of prostate biopsy findings with PET/CT findings demonstrated a sensitivity of 90% for PET/CT. There was a low sensitivity for PET/CT detecting lymph node metastases. A positive uptake was identified in 14 (31.1%) patients; pathohistology revealed positive lymph nodes in 9 patients with only 4 patients exhibiting positive 11C-choline uptake and 5 patients having demonstrated a negative preoperative PET/CT scan. Conclusions: C-PET/CT is a valuable imaging modality for the detection of locally recurrent prostate cancer after radiation therapy. Due to its high sensitivity it might replace prostate biopsy prior to sRPE and it might be of additional value in patients with a negative biopsy but a high suspicion of local recurrence. The value of PET/CT for the identification pN1 disease is of modest value and not reliable. No significant financial relationships to disclose.

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PO-1305 Radiation Therapy for Stage IVB Uterine Cervical Cancer with Supraclavicular Lymph Nodes Metastases

Radiotherapy and Oncology ◽

10.1016/s0167-8140(21)07756-2 ◽

2021 ◽

Vol 161 ◽

pp. S1072

Author(s):

Y. Mukai

Keyword(s):

Cervical Cancer ◽

Radiation Therapy ◽

Lymph Nodes ◽

Uterine Cervical Cancer ◽

Supraclavicular Lymph Nodes ◽

Stage Ivb ◽

Lymph Nodes Metastases

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Long-term clinical outcomes of salvage pelvic radiation therapy for oligo-recurrent pelvic lymph nodes after definitive external-beam radiation therapy for non-metastatic prostate cancer

Journal of Radiation Research ◽

10.1093/jrr/rraa044 ◽

2020 ◽

Vol 61 (4) ◽

pp. 622-628

Author(s):

Genki Edward Sato ◽

Rihito Aizawa ◽

Kiyonao Nakamura ◽

Kenji Takayama ◽

Takahiro Inoue ◽

...

Keyword(s):

Prostate Cancer ◽

Radiation Therapy ◽

Lymph Nodes ◽

External Beam Radiation Therapy ◽

External Beam Radiation ◽

External Beam ◽

Beam Radiation ◽

Pelvic Radiation ◽

Pelvic Lymph Nodes

Abstract Although salvage external-beam radiation therapy (EBRT) is an attractive treatment option for pelvic lymph nodal recurrence (PeNR) in patients with prostate cancer (PCa), limited data are available regarding its long-term efficacy. This study examined the long-term clinical outcomes of patients who underwent salvage pelvic radiation therapy (sPRT) for oligo-recurrent pelvic lymph nodes after definitive EBRT for non-metastatic PCa. Patients who developed PeNR after definitive EBRT and were subsequently treated with sPRT at our institution between November 2007 and December 2015 were retrospectively analyzed. The prescribed dose was 45–50.4 Gy (1.8–2 Gy per fraction) to the upper pelvis, with up to 54–66 Gy (1.8–2 Gy per fraction) for recurrent nodes. Long-term hormonal therapy was used as neoadjuvant and/or adjuvant therapy. The study population consisted of 12 consecutive patients with PeNR after definitive EBRT (median age: 73 years). The median follow-up period was 58.9 months. The 5-year overall survival, PCa-specific survival, biochemical failure-free, clinical failure-free, and castration-resistant PCa-free rates were 82.5, 100.0, 62.3, 81.8, and 81.8%, respectively. No grade 2 or higher sPRT-related late toxicities occurred. In conclusion, more than half of the study patients treated with sPRT had a long-term disease-free status with acceptable morbidities. Moreover, most of the patients maintained hormonal sensitivity. Therefore, this approach may be a promising treatment method for oligo-recurrent pelvic lymph nodes.

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