Irradiación posprostatectomía del cáncer de próstata: Un análisis preliminar

Felix Leborgne; Julieta Mezzera; José Leborgne Deus; Sergio Aguiar

Authors

Felix Leborgne Centro Hospitalario Pereira Rossell, Instituto de Radiología y Centro de Lucha contra el Cáncer, Director
Julieta Mezzera Hospital Italiano, Departamento de Bioestadística, Bioestadística
José Leborgne Deus Hospital Italiano, Radioterapeuta
Sergio Aguiar Hospital Italiano, Radioterapeuta

Keywords:

PROSTATE NEOPLASMS, PROSTATECTOMY

Abstract

The results of radiotherapy after radical prostatectomy for adenocarcinoma of the prostate were reviewed. Sixty two consecutive patients treated from 1994 through 2002 were analysed. Twenty patients received adjuvant radiotherapy due to high risk factors for local recurrence following surgery, and 42 patients received postoperative irradiation for biochemical failure after prostatectomy (17 of these patients had also a palpable recurrence in the pelvis). The five-year actuarial free survival from biochemical failure, cause specific survival and overall survival were 90%, 100% and 100% for patients treated with adjuvant radiotherapy, and 45%, 97% and 95% for those treated with salvage radiotherapy, respectively. In this latter group, when no hormone therapy was added to irradiation, the finding of a decline in their PSA levels at 50 Gy showed a trend towards an improved biochemical control. Late urinary complications after radiotherapy were more frequent than those observed after radical radiotherapy alone as primary treatment

References

1) Leborgne F, Leborgne JH, Zubizarreta E, Ortega B, Leborgne-Deus J, Leborgne F, et al. Cáncer localizado de próstata: experiencia de diez años con radioterapia conformal tridimensional. Rev Med Uruguay 2004; 20(3): 193-201.
2) International Commission on Radiation Units and Measurements (ICRU). ICRU Report 50. Prescribing, recording, and reporting photon beam therapy. Washington: ICRU, 1993.
3) American Society for Therapeutic Radiology and Oncology Consensus Panel. Consensus statement: guidelines for PSA following radiation therapy. Int J Radiat Oncol Biol Phys 1997; 37(5): 1035-41.
4) Thames H, Kuban D, Levy L, Horwitz EM, Kupelian P, Martínez A, et al. Comparison of alternative biochemical failure definitions based on clinical outcome in 4839 prostate cancer patients treated by external beam radiotherapy between 1986 and 1995. Int J Radiat Oncol Biol Phys 2003; 57(4): 929-43.
5) Kaplan EL, Meier P. Non parametric estimation from incomplete observations. J Am Statist Assoc 1958; 53: 457-81.
6) Mantel N. Evaluation of survival data and two new rank order statistics arising in its consideration. Cancer Chemother Rep 1966; 50(3): 163-70.
7) Storey MR, Pollack A, Zagars G, Smith L, Antolak J, Rosen I. Complications from radiotherapy dose escalation in prostate cancer: preliminary results of a randomized trial. Int J Radiat Oncol Biol Phys 2000; 48(3): 635-42.
8) Pound CR, Partin AW, Eisenberger MA, Chan DW, Pearson JD, Walsh PC. Natural history of progression after PSA elevation following radical prostatectomy. JAMA 1999; 281(17): 1591-7.
9) Eisenberger CF, Walsh PC, Eisenberger MA, Chow NH, Partin AW, Mostwin JL, et al. Incidental non-Hodgkin’s lynphoma in patients with localized prostate cancer. Urology 1999; 53: 175-9.
10) Stephenson AJ, Shariat SF, Zelefsky MJ, Kattan MW, Butler EB, The BS, et al. Salvage radiotherapy for recurrent prostate cancer after radical prostatectomy. JAMA 2004; 291(11): 1325-32.
11) Catton C, Gospodarowicz M, Warde P, Panzarella T, Catton P, McLean M, et al. Adjuvant and salvage radiation therapy after radical prostatectomy for adenocarcinoma of the prostate. Radiother Oncol 2001; 59(1): 51-60.
12) Bolla M, van-Poppel H, Collette L, Van-Cangh P, Vekemans K, Da-Pozzo L, et al. Postoperative radiotherapy after radical prostatectomy: a randomised controlled trial (EORTC trial 22911). Lancet 2005; 366(9485): 572-8.
13) Choo R, Hruby G, Hong J, Hong E, DeBoer G, Danjoux C, et al. Positive resection margin and/or pathologic T3 adenocarcinoma of prostate with undetectable postoperative prostate-specific antigen after radical prostatectomy: to irradiate or not?. Int J Radiat Oncol Biol Phys 2002; 52(3): 674-80.
14) Cozzarini C, Bolognesi A, Ceresoli GL, Fiorino C, Rossa A, Bertini R, et al. Role of postoperative radiotherapy after pelvic lymphadenectomy and radical retropubic prostatectomy: a single institute experience of 415 patients. Int J Radiat Oncol Biol Phys 2004; 59(3): 674-83.
15) Taylor N, Kelly JF, Kuban DA, Babaian RJ, Pisters LL, Pollack A. Adjuvant and salvage radiotherapy after radical prostatectomy for prostate cancer. Int J Radiat Oncol Biol Phys 2003; 56(3): 755-63.
16) MacDonald OK, Schild SE, Vora SA, Andrews PE, Ferrigni RG, Novicki DE, et al. Salvage radiotherapy for palpable, locally recurrent prostate cancer after radical prostatectomy. Int J Radiat Oncol Biol Phys 2004; 58(5):1 530-5.
17) Buskirk SJ, Pisansky S, Schild K, Prussak T, Igel T, Wehle R, et al. Results of salvage radiation therapy for a rising serum prostate specific antigen level following radical prostatectomy for prostate cancer. Abstract Nº161. Prostate Cancer Symposium, 2005.
18) Kirkpatrick JP, Calingaert B, Clough RW, Oleson JR, Quaranta BP, Hahn CA et al. Adjuvant and salvage radiotherapy following radical prostatectomy. Abstract Nº 2190. Int J Rad Oncol Biol Phys 2004; 60(Supl): S450-1.
19) Katz MS, Zelefsky MJ, Venkatraman ES, Fuks Z, Hummer A et al. Predictors of biochemical outcome with salvage conformal radiotherapy after radical prostatectomy for prostate cancer. JCO 2003; 21: 483-9.
20) Do T, Giatri Dave G, Parker R, Kagan R. Serum PSA Evaluations during salvage radiotherapy for post-prostatectomy biochemical failures as prognosticators for treatment outcomes. Int J Rad Oncol Biol Phys 2001; 50: 1220-5.
21) Collie AC, Buskirk SJ, Wehle MJ, Young PR, Petrou SP, Broderick GA et al. Evaluation of chronic toxicity following radiation therapy for patients with a rising PSA status post prostatectomy. Int J Rad Oncol Biol Phys 2004; 60(Supl): S478.