EP-1385: A comparative study between radical RT and radical prostatectomy in locally advanced prostate cancer

P. Gupta, N. Rastogi, K. Sharmad, K. Das, R. Kapoor, A. Mandhani, S. Kumar
2016 Radiotherapy and Oncology  
S646 ESTRO 35 2016 _____________________________________________________________________________________________________ complemented by a boost to local recurrence to a total dose of 72 Gy. In case of no macroscopic tumor recurrence the total dose was 66.6 Gy. Results: MRI was performed in 233 patients and PET/CT was performed in 169 patients. A local recurrence in the prostate bed could be detected in 123 patients with a median volume of 0.5 ml (range, 0.03 -125.00 ml). The median follow-up
more » ... me after RT was 49.4 months (range, 7.3 -86.1 months). A total of 85 patients experienced a biochemical failure with a median time of 19.8 months (range, 1.9 -76.1 months) after sRT. Median PSA level at the time of recurrence was 0.91 ng/ml (range, 0.01 -2224.00 ng/ml). The median BRFS after radiation therapy was 73 months. The estimated 3-and 5year bRFS was 72% and 55%, respectively. On multivariate analysis, Gleason Score (hazard ratio, 6.946; p = 0.006) and pre-RT PSA level (hazard ratio, 2.265; p = 0.022) were statistically significant predictors for bRFS. bRFS was similar in patients with a macroscopic recurrence in either MRI or PET/CT compared to patients without a macroscopic recurrence. 5-year overall survival was 91% and 5-year cancer-specific survival was 96%. Grade 3 gastrointestinal toxicity was observed in 4 patients and 3 patients showed grade 3 genitourinary toxicities. No grade 4 gastrointestinal or genitourinary side effects were reported. Conclusion: Gleason score and pre-RT PSA were important predictors for bRFS. The dose in salvage radiotherapy should be increased to 72 Gy to prevent an early recurrence after sRT in patients with a macroscopic recurrence. A higher total dose of up to 72 Gy was well tolerated in this cohort of patients. EP-1383 PSA kinetics in prostate cancer patients after SBRT radiotherapy using CyberKnife.
doi:10.1016/s0167-8140(16)32635-4 fatcat:czscl7otnbanjinvneuq2pv6ri