Management of Isolated Local Failures Following Stereotactic Body Radiation Therapy for Low to Intermediate Risk Prostate Cancer

• DOI: 10.3389/fonc.2020.551491
• Publication Date: 2020-10-29T09:23:05Z
• Authors: Nima Aghdam; Abigail N. Pepin; Michael Creswell; Kristin Hsieh; Clayton Smith; Nicolette Drescher; Malika Danner; Marilyn Ayoob; Thomas Yung; Siyuan Lei; Deepak Kumar; Brian Timothy Col...; Jonathan W. Lischalk; Pranay Krishnan; Simeng Suy; John Lynch; Guarav Bandi; Ryan Andrew Hankins; Sean P. Collins
• Keywords: 03 medical and health sciences; SBRT; 0302 clinical medicine; Oncology; isolated local failure; Neoplasms. Tumors. Oncology. Including cancer and carcinogens; salvage therapy; prostate cancer; CTC; RC254-282; 3. Good health

Background: Stereotactic body radiation therapy (SBRT) is a safe and effective treatment option for patients with low to intermediate risk prostate cancer (1). SBRT results in very PSA nadirs secondary the delivery of high biologically doses. Studies reporting on diagnosis, confirmation, management salvageable isolated local failures (ILF) are limited. This study aims determine incidence approach ILF after large single institution cohort. Method: All or localized treated at Georgetown University Hospital were eligible this study. Treatment was delivered using robotic doses 35-36.25 Gy five fractions. diagnosed multiparametric MRI and/or biopsy prompted by rising levels achieving long-term nadir. Patient's characteristics extracted from prospective institutional quality life trial (IRB 2009-510). Type salvage post-salvage determined subsequent follow-up chart review. Results: Between December 2008 August 2018, 998 men inclusion analysis. Twenty-four (low risk, n = 5; 19) found have within either (n 20). Median pre-treatment 7.55 ng/ml. time diagnosis 72 months (24-110 months) median 2.8 ng/ml (0.7-33 ng/ml). doubling 17 (5-47 months). Thirteen proven proceeded (cryotherapy 12, HIFU 1). Of 12 who underwent cryotherapy, 7 had post-treatment <0.1 One patient experienced urethral-cutaneous fistula (grade 3 toxicity). Conclusion: The recurrence rare our Diagnosis post-SBRT continues evolve. Our report highlights importance early utilization confirmatory relatively long Additionally, undetectable supports role Further research needed appropriate selection modality population.