Stereotactic body radiation therapy after radical prostatectomy: current status and future directions
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
Hull GW, Rabbani F, Abbas F et al (2002) Cancer control with radical prostatectomy alone in 1,000 consecutive patients. J Urol 167:528–534. https://doi.org/10.1016/S0022-5347(01)69079-7
Roehl KA, Han M, Ramos CG et al (2004) Cancer progression and survival rates following anatomical radical retropubic prostatectomy in 3,478 consecutive patients: long-term results. J Urol 172:910–914. https://doi.org/10.1097/01.ju.0000134888.22332.bb
Stephenson AJ, Scardino PT, Kattan MW et al (2007) Predicting the outcome of salvage radiation therapy for recurrent prostate cancer after radical prostatectomy. J Clin Oncol 25:2035–2041. https://doi.org/10.1200/JCO.2006.08.9607
Freedland SJ, Humphreys EB, Mangold LA et al (2005) Risk of prostate cancer-specific mortality following biochemical recurrence after radical prostatectomy. JAMA 294:433–439. https://doi.org/10.1001/jama.294.4.433
Bolla M, van Poppel H, Tombal B et al (2012) Postoperative radiotherapy after radical prostatectomy for high-risk prostate cancer: long-term results of a randomised controlled trial (EORTC trial 22911). Lancet Lond Engl 380:2018–2027. https://doi.org/10.1016/S0140-6736(12)61253-7
Wiegel T, Bartkowiak D, Bottke D et al (2014) Adjuvant radiotherapy versus wait-and-see after radical prostatectomy: 10-year follow-up of the ARO 96–02/AUO AP 09/95 trial. Eur Urol 66:243–250. https://doi.org/10.1016/j.eururo.2014.03.011
Thompson IM, Tangen CM, Paradelo J et al (2009) Adjuvant radiotherapy for pathological T3N0M0 prostate cancer significantly reduces risk of metastases and improves survival: long-term followup of a randomized clinical trial. J Urol 181:956–962. https://doi.org/10.1016/j.juro.2008.11.032
Hackman G, Taari K, Tammela TL et al (2019) Randomised trial of adjuvant radiotherapy following radical prostatectomy versus radical prostatectomy alone in prostate cancer patients with positive margins or extracapsular extension. Eur Urol 76:586–595. https://doi.org/10.1016/j.eururo.2019.07.001
Tilki D, Chen M-H, Wu J et al (2021) Adjuvant versus early salvage radiation therapy for men at high risk for recurrence following radical prostatectomy for prostate cancer and the risk of death. J Clin Oncol 39:2284–2293. https://doi.org/10.1200/JCO.20.03714
Mottet N, van den Bergh RCN, Briers E et al (2021) EAU-EANM-ESTRO-ESUR-SIOG guidelines on prostate cancer—2020 update. Part 1: screening, diagnosis, and local treatment with curative intent. Eur Urol 79:243–262. https://doi.org/10.1016/j.eururo.2020.09.042
NCCN Clinical Practice Guidelines in Oncology : Prostate Cancer. V 3.2022
Parker CC, Clarke NW, Cook AD et al (2020) Timing of radiotherapy after radical prostatectomy (RADICALS-RT): a randomised, controlled phase 3 trial. Lancet Lond Engl 396:1413–1421. https://doi.org/10.1016/S0140-6736(20)31553-1
Kneebone A, Fraser-Browne C, Duchesne GM et al (2020) Adjuvant radiotherapy versus early salvage radiotherapy following radical prostatectomy (TROG 08.03/ANZUP RAVES): a randomised, controlled, phase 3, non-inferiority trial. Lancet Oncol 21:1331–1340. https://doi.org/10.1016/S1470-2045(20)30456-3
Sargos P, Chabaud S, Latorzeff I et al (2020) Adjuvant radiotherapy versus early salvage radiotherapy plus short-term androgen deprivation therapy in men with localised prostate cancer after radical prostatectomy (GETUG-AFU 17): a randomised, phase 3 trial. Lancet Oncol 21:1341–1352. https://doi.org/10.1016/S1470-2045(20)30454-X
Vale CL, Fisher D, Kneebone A et al (2020) Adjuvant or early salvage radiotherapy for the treatment of localised and locally advanced prostate cancer: a prospectively planned systematic review and meta-analysis of aggregate data. Lancet 396:1422–1431. https://doi.org/10.1016/S0140-6736(20)31952-8
Michalski JM, Lawton C, El Naqa I et al (2010) Development of RTOG consensus guidelines for the definition of the clinical target volume for postoperative conformal radiation therapy for prostate cancer. Int J Radiat Oncol 76:361–368. https://doi.org/10.1016/j.ijrobp.2009.02.006
Poortmans P, Bossi A, Vandeputte K et al (2007) Guidelines for target volume definition in post-operative radiotherapy for prostate cancer, on behalf of the EORTC Radiation Oncology Group. Radiother Oncol J Eur Soc Ther Radiol Oncol 84:121–127. https://doi.org/10.1016/j.radonc.2007.07.017
Sidhom MA, Kneebone AB, Lehman M et al (2008) Post-prostatectomy radiation therapy: consensus guidelines of the Australian and New Zealand Radiation Oncology Genito-Urinary Group. Radiother Oncol J Eur Soc Ther Radiol Oncol 88:10–19. https://doi.org/10.1016/j.radonc.2008.05.006
Wiltshire KL, Brock KK, Haider MA et al (2007) Anatomic boundaries of the clinical target volume (prostate bed) after radical prostatectomy. Int J Radiat Oncol Biol Phys 69:1090–1099. https://doi.org/10.1016/j.ijrobp.2007.04.068
Robin S, Jolicoeur M, Palumbo S et al (2021) Prostate bed delineation guidelines for postoperative radiation therapy: on behalf of the francophone group of urological radiation therapy. Int J Radiat Oncol Biol Phys 109:1243–1253. https://doi.org/10.1016/j.ijrobp.2020.11.010
Dal Pra A, Dirix P, Khoo V et al (2023) ESTRO ACROP guideline on prostate bed delineation for postoperative radiotherapy in prostate cancer. Clin Transl Radiat Oncol 41:100638. https://doi.org/10.1016/j.ctro.2023.100638
Swanson GP, Hussey MA, Tangen CM et al (2007) Predominant treatment failure in postprostatectomy patients is local: analysis of patterns of treatment failure in SWOG 8794. J Clin Oncol 25:2225–2229. https://doi.org/10.1200/JCO.2006.09.6495
Shen G, Deng H, Hu S, Jia Z (2014) Comparison of choline-PET/CT, MRI, SPECT, and bone scintigraphy in the diagnosis of bone metastases in patients with prostate cancer: a meta-analysis. Skelet Radiol 43:1503–1513. https://doi.org/10.1007/s00256-014-1903-9
Perera M, Papa N, Christidis D et al (2016) Sensitivity, specificity, and predictors of positive 68ga-prostate-specific membrane antigen positron emission tomography in advanced prostate cancer: a systematic review and meta-analysis. Eur Urol 70:926–937. https://doi.org/10.1016/j.eururo.2016.06.021
Roach PJ, Francis R, Emmett L et al (2018) The impact of 68 Ga-PSMA PET/CT on management intent in prostate cancer: results of an Australian prospective multicenter study. J Nucl Med 59:82–88. https://doi.org/10.2967/jnumed.117.197160
Gonzalez-Moya A, Supiot S, Seegers V et al (2021) Mapping of recurrence sites following adjuvant or salvage radiotherapy for prostate cancer patients. Front Oncol 11:787347. https://doi.org/10.3389/fonc.2021.787347
Miralbell R, Roberts SA, Zubizarreta E, Hendry JH (2012) Dose-fractionation sensitivity of prostate cancer deduced from radiotherapy outcomes of 5,969 patients in seven international institutional datasets: α/β = 1.4 (0.9–2.2) Gy. Int J Radiat Oncol 82:e17–e24. https://doi.org/10.1016/j.ijrobp.2010.10.075
Chin S, Fatimilehin A, Walshaw R et al (2020) Ten-year outcomes of moderately hypofractionated salvage postprostatectomy radiation therapy and external validation of a contemporary multivariable nomogram for biochemical failure. Int J Radiat Oncol Biol Phys 107:288–296. https://doi.org/10.1016/j.ijrobp.2020.01.008
Syndikus I, Pickles T, Kostashuk E, Sullivan LD (1996) Postoperative radiotherapy for stage pT3 carcinoma of the prostate: improved local control. J Urol 155:1983–1986
Kruser TJ, Jarrard DF, Graf AK et al (2011) Early hypofractionated salvage radiotherapy for postprostatectomy biochemical recurrence. Cancer 117:2629–2636. https://doi.org/10.1002/cncr.25824
Arcangeli G, Saracino B, Gomellini S et al (2010) A prospective phase III randomized trial of hypofractionation versus conventional fractionation in patients with high-risk prostate cancer. Int J Radiat Oncol Biol Phys 78:11–18. https://doi.org/10.1016/j.ijrobp.2009.07.1691
Buyyounouski MK, Pugh S, Chen RC et al (2021) Primary endpoint analysis of a randomized phase III trial of hypofractionated vs. conventional post-prostatectomy radiotherapy: NRG Oncology GU003. Int J Radiat Oncol 111:S2–S3. https://doi.org/10.1016/j.ijrobp.2021.07.041
Cozzarini C, Fiorino C, Deantoni C et al (2014) Higher-than-expected severe (Grade 3–4) late urinary toxicity after postprostatectomy hypofractionated radiotherapy: a single-institution analysis of 1176 patients. Eur Urol 66:1024–1030. https://doi.org/10.1016/j.eururo.2014.06.012
Lewis SL, Patel P, Song H et al (2016) Image guided hypofractionated postprostatectomy intensity modulated radiation therapy for prostate cancer. Int J Radiat Oncol Biol Phys 94:605–611. https://doi.org/10.1016/j.ijrobp.2015.11.025
Moher D, Liberati A, Tetzlaff J, Altman D (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med
Lucchini R, Franzese C, Vukcaj S et al (2022) Acute toxicity and quality of life in a post-prostatectomy ablative radiation therapy (POPART) multicentric trial. Curr Oncol 29:9349–9356. https://doi.org/10.3390/curroncol29120733
Ma TM, Ballas LK, Wilhalme H et al (2023) Quality-of-life outcomes and toxicity profile among patients with localized prostate cancer after radical prostatectomy treated with stereotactic body radiation: the SCIMITAR multicenter phase 2 trial. Int J Radiat Oncol 115:142–152. https://doi.org/10.1016/j.ijrobp.2022.08.041
Sampath S, Frankel P, del Vecchio B et al (2020) Stereotactic body radiation therapy to the prostate bed: results of a phase 1 dose-escalation trial. Int J Radiat Oncol 106:537–545. https://doi.org/10.1016/j.ijrobp.2019.11.005
Ballas LK, Luo C, Chung E et al (2019) Phase 1 trial of SBRT to the prostate fossa after prostatectomy. Int J Radiat Oncol 104:50–60. https://doi.org/10.1016/j.ijrobp.2018.12.047
Ozyigit G, Onal C, Beduk Esen CS et al (2023) Treatment outcomes of postoperative ultra-hypofractionated stereotactic body radiotherapy in prostate cancer. Urol Oncol Semin Orig Investig. https://doi.org/10.1016/j.urolonc.2022.12.001
Emmett L, van Leeuwen PJ, Nandurkar R et al (2017) Treatment outcomes from 68Ga-PSMA PET/CT-informed salvage radiation treatment in men with rising PSA after radical prostatectomy: prognostic value of a negative PSMA PET. J Nucl Med 58:1972–1976. https://doi.org/10.2967/jnumed.117.196683
Dirix P, van Walle L, Deckers F et al (2017) Proposal for magnetic resonance imaging-guided salvage radiotherapy for prostate cancer. Acta Oncol Stockh Swed 56:27–32. https://doi.org/10.1080/0284186X.2016.1223342
Benziane-Ouaritini N, Zilli T, Giraud A et al (2023) Prostatectomy bed image-guided dose-escalated salvage radiotherapy (SPIDER): an international multicenter retrospective study. Eur Urol Oncol. https://doi.org/10.1016/j.euo.2023.02.013
Francolini G, Garlatti P, Di Cataldo V et al (2023) Three months’ PSA and toxicity from a prospective trial investigating stereotactic salvage radiotherapy for macroscopic prostate bed recurrence after prostatectomy—STARR (NCT05455736). Cancers 15:992. https://doi.org/10.3390/cancers15030992
Francolini G, Jereczek-Fossa BA, Di Cataldo V et al (2020) Stereotactic radiotherapy for prostate bed recurrence after prostatectomy, a multicentric series: Stereotactic radiotherapy in prostate relapse. BJU Int 125:417–425. https://doi.org/10.1111/bju.14924
Francolini G, Loi M, Di Cataldo V et al (2022) Stereotactic re-irradiation in recurrent prostate cancer after previous postoperative or definitive radiotherapy: long-term results after a median follow-up of 4 years. Clin Oncol R Coll Radiol G B 34:50–56. https://doi.org/10.1016/j.clon.2021.11.002
Francolini G, Jereczek-Fossa BA, Di Cataldo V et al (2022) Stereotactic or conventional radiotherapy for macroscopic prostate bed recurrence: a propensity score analysis. Radiol Med (Torino) 127:449–457. https://doi.org/10.1007/s11547-022-01465-w
Detti B, Bonomo P, Masi L et al (2016) CyberKnife stereotactic radiotherapy for isolated recurrence in the prostatic bed. World J Urol 34:311–317. https://doi.org/10.1007/s00345-015-1613-5
Olivier J, Basson L, Puech P et al (2019) Stereotactic re-irradiation for local recurrence in the prostatic bed after prostatectomy: preliminary results. Front Oncol 9:71. https://doi.org/10.3389/fonc.2019.00071
Caroli P, Colangione SP, De Giorgi U et al (2020) 68Ga-PSMA-11 PET/CT-guided stereotactic body radiation therapy retreatment in prostate cancer patients with PSA failure after salvage radiotherapy. Biomedicines 8:536. https://doi.org/10.3390/biomedicines8120536
Perennec T, Vaugier L, Toledano A et al (2021) Stereotactic re-irradiation for local recurrence after radical prostatectomy and radiation therapy: a retrospective multicenter study. Cancers 13:4339. https://doi.org/10.3390/cancers13174339
Archer P, Marvaso G, Detti B et al (2023) Salvage stereotactic reirradiation for local recurrence in the prostatic bed after prostatectomy: a retrospective multicenter study. Eur Urol Oncol. https://doi.org/10.1016/j.euo.2023.03.005
Guimas V, Supiot S, Rio E (2023) REPAIR-GETUG P16: stereotactic reirradiation with metformin for relapse in irradiated prostate bed, ESTRO 2023 PO—1527
Patel KR, Rowe LS, Schott E et al (2022) A phase 1 trial of highly conformal, hypofractionated postprostatectomy radiation therapy. Adv Radiat Oncol 7:101024. https://doi.org/10.1016/j.adro.2022.101024
Ghadjar P, Hayoz S, Bernhard J et al (2021) Dose-intensified versus conventional-dose salvage radiotherapy for biochemically recurrent prostate cancer after prostatectomy: the SAKK 09/10 randomized phase 3 trial. Eur Urol
Tilki D, Chen M-H, Wu J et al (2023) Prostate-specific antigen level at the time of salvage therapy after radical prostatectomy for prostate cancer and the risk of death. J Clin Oncol 41:2428–2435. https://doi.org/10.1200/JCO.22.02489
Panebianco V, Villeirs G, Weinreb JC et al (2021) Prostate magnetic resonance imaging for local recurrence reporting (PI-RR): international consensus-based guidelines on multiparametric magnetic resonance imaging for prostate cancer recurrence after radiation therapy and radical prostatectomy. Eur Urol Oncol 4:868–876. https://doi.org/10.1016/j.euo.2021.01.003
Hearn N, Blazak J, Vivian P et al (2021) Prostate cancer GTV delineation with biparametric MRI and 68Ga-PSMA-PET: comparison of expert contours and semi-automated methods. Br J Radiol 94:20201174. https://doi.org/10.1259/bjr.20201174
Draulans C, Pos F, Smeenk RJ et al (2021) 68Ga-PSMA-11 PET, 18F-PSMA-1007 PET, and MRI for gross tumor volume delineation in primary prostate cancer: intermodality and intertracer variability. Pract Radiat Oncol 11:202–211. https://doi.org/10.1016/j.prro.2020.11.006
Tendulkar RD, Agrawal S, Gao T et al (2016) Contemporary update of a multi-institutional predictive nomogram for salvage radiotherapy after radical prostatectomy. J Clin Oncol 34:3648–3654. https://doi.org/10.1200/JCO.2016.67.9647