ESTRO 2022 - Abstract Book

S1160

Abstract book

ESTRO 2022

PO-1367 Salvage radiotherapy after prostatectomy for biochemical relapse

J.A. Domínguez Rullán 1 , V. Duque Santana 1 , A. Hervás Morón 1 , F. López Campos 1 , M. Valero 1 , C. Vallejo Ocaña 1 , D. Sevillano Martínez 2 , J.D. García Fuentes 2 , S. Sancho García 1 1 Hospital Universitario Ramón y Cajal, Radiation Oncology, Madrid, Spain; 2 Hospital Universitario Ramón y Cajal, Medical Physics, Madrid, Spain Purpose or Objective To determinate the factors related to outcome in patients presenting biochemical relapse after radical prostatectomy treated with salvage radiotherapy. Materials and Methods From 2002 to 2014, 168 patients were treated at our institution with salvage radiotherapy after radical prostatectomy for biochemical relapse. Overall survival (OS) and biochemical-relapse free survival (BRFS) were calculated using Kaplan-Meier and Cox-regression was used to assess possible prognostic factors. Results Mean age was 63 years (range 41-74). Gleason Score (GS) at diagnosis was ≤ 6 in 49.1% of patients, GS 7 in 42.2% and 6.2% GS ≥ 8. All patients underwent radical prostatectomy with pelvic lymphadenectomy in 50% of cases. Neoadjuvant androgen deprivation therapy (NADT) before surgery was given to 49.5%. The distribution of patients by pT stage was pT2a/b(40.8%), pT2c (36.5%), pT3(16.2%) and pT4(0.6%). Gleason Score was ≤ 6 in 30.7% of patients, Gleason 7 (57.4%) and Gleason ≥ 8 in 12% of patients. Positive surgical margins were reported in 40.5% of cases. Mean time to radiotherapy (RT) was 34 months (4-146) and mean PSA beforse salvage was 0.88ng/ml. Median follow-up was 118 months (range 6-233). 5 and 10-year OS were 93.1% and 80.2% and BRFS 89.5% and 75.5%, respectively. Local recurrence was seen in 3 patients (1.8%), nodal recurrence in 8.9% and distant metastasis in 12.5%. Gleason Score, T stage and PSA levels at diagnosis and before salvage RT were significant predictors of BRFS. Positive surgical margins and absence of NADT were not related with worse BRFS. Conclusion Salvage radiotherapy for biochemical relapse after prostatectomy provides good survival and biochemical control, comparable to those reported in the literature. Patients with higher PSA levels before RT have increased risk of biochemical recurrence so early salvage radiotherapy should be recommended. Purpose or Objective Purpose : In patients with prostate cancer, a little known aspect in the post-operative setting is whether irradiating the lymph node chains instead of the prostate bed alone can confer an additional benefit in terms of disease recurrence. Purpose of our study was to demonstrate an improvement of biochemical control by post-operative nodal irradiation respect to prostate-only irradiation in patients with prostate cancer undergoing radical prostatectomy. Materials and Methods Material and Methods : We evaluated 404 patients with prostate cancer treated with adjuvant or salvage RT at Radiotherapy Unit of Pisa University Hospital from January 2011 to December 2011. All patients were treated using VMAT radiotherapy. ADT was administered to patients with high-risk prostate cancer in accordance with EAU guidelines. We studied biochemical progression free survival for each category of risk according to the NCCN classification. We did multivariate analysis of Progression Free Survival factors risk by step-wise method. Results Results : Evaluating all patients with a median follow-up of 62 months, we did not found statistically significant advantage (p=0,77) by nodal radiotherapy; however, in the analysis of sub categories, we found a trend toward a significant advantage in prophylactic nodal irradiation in 140 patients with low and intermediate risk class (p=0,056). Conclusion Conclusion : Our study highlights how the whole pelvic nodal prophylactic radiation therapy does not offer an additional benefit in all patients, but only in selected patients with low-intermediate prostate cancer. Larger and prospective studies are needed to confirm our results. PO-1368 Prophylactic pelvic nodal RT vs only prostate bed irradiation in patients with prostatic cancer T. Fuentes 1 , E. Calistri 1 , A. Sainato 1 , B. Manfredi 1 , F. Matteucci 1 , R. Morganti 1 , F. Pasqualetti 1 , F. Paiar 1 1 University Hospital of Pisa, Oncological Radiotherapy, Pisa, Italy

PO-1369 Salvage SBRT re-irradiation for local recurrence of prostate cancer

R.C. Sigillo 1 , G. Facondo 2 , G. Vullo 2 , A. Bertozzi 1 , M.F. Osti 1 , M. Valeriani 1

1 Sapienza Università di Roma, AOU Sant'Andrea Roma, Oncologic Radiotherapy, Rome, Italy; 2 Sapienza Università di Roma, AOU Sant'Andrea Roma, Oncologic Radiotherapy, rome, Italy