SBRT in the treatment of prostate cancer nodal relapse: A single-center experience and a brief literature review

Abstract

Nodal recurrence after primary treatment of prostate cancer is increasingly encountered in the clinic. Although there is no specific recommended technique and dose schedule for radiotherapy applications, stereotactic body radiotherapy (SBRT) applications have been reported in most studies. This study aimed to retrospectively report the cases that underwent SBRT for prostate cancer nodal recurrence. Patients diagnosed with prostate cancer due to isolated nodal recurrence and undergoing SBRT were evaluated retrospectively. The patients' radiotherapy doses and target volume details were obtained from the technical file and planning system patient files and patient interviews. The primary endpoint of the study was a disease-free survey (DFS). Data were recorded and analyzed using SPSS ver. 24. The time from relapsed nodal SBRT to recurrence in or out of the SBRT area was defined as DFS after nodal RT. Kaplan Meier test was used for survival analysis. In the current study, a total of 10 field irradiation of 8 patients with prostate cancer who underwent RT for nodal recurrence between 16.8.18-18.2.21 in Ankara City Hospital were evaluated retrospectively. In the follow-up after diagnosis, isolated nodal recurrence developed in all the patients. The median DFSprimer was 6.9 (range 1.1-31.3) months. Median follow-up time after RT for nodal recurrence mean follow-up is 7 months (range 1-31.3). The median DFSafternodalRT was 3.5 months (range 1-26 months). During the follow-up period, intra-field recurrence was observed in one patient and extra-field recurrence was observed in two patients, and a total of 3 recurrences were observed. According to the results of the analysis, N stage at the time of diagnosis with DFSafternodalRT (p0.24); T stage at diagnosis (p0.47); diagnosis GS (p0.28); risk group at the time of diagnosis (p0.53); initial therapy (p0.67); baseline RT area (p0.057), presence or absence of surgery (p0.35); type of surgery (p0.64); PSA at diagnosis (p0.56); the relationship between the first RT dose (p0.053) were not statistically significant. The median duration of local-DFSafternodalRT is 3.7 months (Range 1-30 months). During the follow-up period, only one patient in the irradiated area had a recurrence. This case was unresponsive after RT and progression were observed. Nodal recurrence after RT Local-DFSafternodalRT diagnosis N stage (p0.28); T stage at diagnosis (p.36); diagnosis GS (p0.24); PSA at diagnosis (p0.52); risk group at the time of diagnosis (p0.57); initial therapy (p0.71); presence or absence of surgery (p0.38); type of surgery (p0.68); The relationship between the first RT total dose (p0.056), first RT areas (p0.054) were not statically significant. The only patient who did not respond and had local recurrence was the case who progressed after treatment, the primary RT area was quite large, and LV and PLN irradiation of the prostate lodge was performed. SBRT is a treatment choice for nodal recurrent prostate cancer; however, optimal dose scheme and timing are not determined. [Med-Science 2022; 11(2.000): 633-8]

Keywords

• prostate cancer
• recurrence
• radiotherapy