Salvage Stereotactic Body Radiation Therapy for Local Prostate Cancer Recurrence After Radiation Therapy A Retrospective Multicenter Study of the GETUG

David Pasquier (1, 2) , Geoffrey Martinage (2) , Guillaume Janoray (3, 4) , Damaris Patricia Rojas (5) , Dario Zerini (5) , Flora Goupy (6) , Renaud de Crevoisier (7, 6) , Emilie Bogart (2) , Gilles Calais (3, 4) , Alain Toledano (8) , Laurent Chauveinc (8) , Nathaniel Scher (8) , Pierre Yves Bondiau (9, 10) , Jean Michel Hannoun-Levi (9, 10) , Marlon Silva (11) , Emmanuel Meyer (11) , Philippe Nickers (12, 2) , Thomas Lacornerie (2) , Barbara Alicja Jereczek-Fossa (5) , Eric Lartigau (1, 2)

1 CRIStAL - Centre de Recherche en Informatique, Signal et Automatique de Lille - UMR 9189
2 UNICANCER/Lille - Centre Régional de Lutte contre le Cancer Oscar Lambret [Lille]
3 CHRU Tours - Centre Hospitalier Régional Universitaire de Tours
4 Université Francois Rabelais [Tours]
5 UNIMI - Università degli Studi di Milano = University of Milan
6 CRLCC - Centre Eugène Marquis
7 LTSI - Laboratoire Traitement du Signal et de l'Image
8 Centre de Radiothérapie Hartmann [Levallois-Perret]
9 UNICANCER/CAL - Centre de Lutte contre le Cancer Antoine Lacassagne [Nice]
10 UCA - Université Côte d'Azur
11 UNICANCER/CRLC - Centre Régional de Lutte contre le Cancer François Baclesse [Caen]
12 CHRU Lille - Centre Hospitalier Régional Universitaire [Lille]

Purpose: To assess the efficacy and safety of salvage stereotactic body radiation therapy (SBRT) in patients with biopsy-proven local prostate cancer recurrence after radiation therapy. Methods and materials: Between April 2010 and January 2017, 100 patients were included in 7 centers. Disease extension was assessed by pelvic multiparametric magnetic resonance imaging and choline positron emission tomography in 87% and 94% of patients, respectively. The median time interval between the 2 treatments was 7.5 years (range, 2-18). Median prostate-specific antigen at recurrence was 4.3 ng/mL (range, 2-38). Median SBRT dose was 36 Gy (range, 25-36.25) in 6 fractions (range, 5-6), every other day. Thirty-four percent of patients were treated by androgen deprivation therapy for a median duration of 12 months. Toxicity was assessed according to Common Terminology Criteria for Adverse Events version 4.03. Results: Median follow-up was 29.3 months (range, 4-91). Second biochemical recurrence-free survival rate at 3 years was 55% (95% confidence interval [CI], 42%-66%). The initial D'Amico group, time interval after first radiation therapy, and SBRT dose were prognostic factors of biochemical recurrence-free survival in multivariate analysis (P = .09, P = .025, P = .018, respectively). No patient developed acute gastrointestinal toxicity of grade >1; rates of acute genitourinary toxicity of grade 2 and 3 were 8% and 1%, respectively. The actuarial 3-year grade ≥2 genitourinary and gastrointestinal toxicity was 20.8% (95% CI, 13%-29%) and 1% (95% CI, 0.1%-5.1%), respectively. One patient presented with neuritis of grade 3. Conclusions: With a short follow-up, this study shows that salvage SBRT allows for encouraging control and acceptable toxicity. Further prospective studies are necessary to confirm these preliminary results and to determine late toxicity.

Domains: Life Sciences [q-bio]; Bioengineering

David Pasquier, Geoffrey Martinage, Guillaume Janoray, Damaris Patricia Rojas, Dario Zerini, et al.. Salvage Stereotactic Body Radiation Therapy for Local Prostate Cancer Recurrence After Radiation Therapy A Retrospective Multicenter Study of the GETUG. International Journal of Radiation Oncology, Biology, Physics, 2019, 105 (4), pp.727-734. ⟨10.1016/j.ijrobp.2019.07.012⟩. ⟨hal-02280264⟩