Stereotactic body radiation therapy after radical prostatectomy: current status and future directions

Springer Science and Business Media LLC - Tập 41 - Trang 3333-3344 - 2023
Jennifer Le Guevelou1, Nicolas Magne2, Felipe Counago3, Juan Martin Magsanoc4, Matthieu Vermeille5, Renaud De Crevoisier1, Nicolas Benziane-Ouaritini2, Piet Ost6,7, Tamim Niazi8, Stéphane Supiot9, Paul Sargos2
1Radiation Oncology Department, Centre Eugène-Marquis, Rennes, France
2Department of Radiotherapy, Institut Bergonié, Bordeaux, France
3Radiation Oncology Department, GenesisCare Madrid Clinical Director, San Francisco de Asis and La Milagrosa Hospitals, National Chair of Research and Clinical Trials, GenesisCare, Madrid, Spain
4Radiation Oncology Department, St Lukes Hospital, Quezon City, Philippines
5Radiation Oncology Department, Genolier Swiss Radio-Oncology Network, Genolier, Switzerland
6Radiation Oncology Department, Iridium Network, Antwerp, Belgium
7Department of Human Structure and Repair, Ghent University, Ghent, Belgium
8Department of Radiation Oncology, Jewish General Hospital, Montreal, Canada
9Radiation Oncology Department, Institut de Cancérologie de l’Ouest, Nantes, France

Tóm tắt

Around 40% of men with intermediate-risk or high-risk prostate cancer will experience a biochemical recurrence after radical prostatectomy (RP). The aim of this review is to describe both toxicity and oncological outcomes following stereotactic body radiation therapy (SBRT) delivered to the prostate bed (PB). In april 2023, we performed a systematic review of studies published in MEDLINE or ClinicalTrials.gov according to Preferred Reporting Items for Systematic Reviews, using the keywords “stereotactic radiotherapy” AND “postoperative” AND “prostate cancer”. A total of 14 studies assessing either adjuvant or salvage SBRT to the whole PB or macroscopic local recurrence (MLR) within the PB, and SBRT on radiorecurrent MLR within the PB were included. Doses delivered to either whole PB or MLR between 30 to 40 Gy are associated with a low rate of late grade ≥ 2 genitourinary (GU) toxicity, ranging from 2.2 to 15.1%. Doses above 40 Gy are associated with increased rate of late GU toxicity, raising up to 38%. Oncological outcomes should be interpreted with caution, due to both short follow-up, heterogeneous populations and androgen deprivation therapy (ADT) use. PB or MLR SBRT delivered at doses up to 40 Gy appears safe with relatively low late severe GU toxicity rates. Caution is needed with dose-escalated RT schedules above 40 Gy. Further prospective trials are eagerly awaited in this disease setting.

Tài liệu tham khảo

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