ESTRO 2024 - Abstract Book

S2388

Clinical - Urology

ESTRO 2024

between patients treated on pelvic lymph-nodes and para-aortic lymph-nodes. Patients with pelvic disease had a longer PFS than those with para-aortic disease: specifically 66,3% and 45,9% at 1 year, 35,2% and 22,4% at 3 years, 30,2% and 14,9% at 5 years with a median PFS of 20 and 11 months (p=0,042). BRFS showed only a trend towards statistical significance (median 16 months in pelvic group versus 9 months in para-aortic group; p=0,07). Patients treated on pelvic disease recur to the pelvis again in 51.8% cases, while those treated on para-aortic nodes in 12.9% cases (p=0,0006). The absolute rate of subsequent distant metastases was not significantly different between para aortic and pelvic lymph nodes (38,7% versus 26%; p=0.07). A propensity score matching 1:1 was performed, and there were identified 30 patients for each group considering four main categories: disease free interval, PSA at time of SBRT, number of lymph nodes treated, and risk class at diagnosis; no statistically significant differences for all the study end-points were detected.

Conclusion:

Patients affected by para-aortic disease might have PFS comparable to pelvic disease at the matched analysis. We identified several predictive factors of relapse, as well pattern of relapse. Local control in our cohort is high in both para aortic and pelvic lymph nodes. Toxicity is very limited. The results of the present study further support the use of SBRT also to para aortic metastases with the aim to delay ADT start, or eventually prolong its duration.

Keywords: oligometastases; SBRT; prostate cancer

1091

Poster Discussion

Early salvage radiotherapy in patients with prostate cancer: a prospective study of 721 patients.

Letizia Cavallini 1,2 , Alessandra Arcelli 2 , Filippo Mammini 1,2 , Silvia Paolinelli 1,2 , Erika Galietta 1,2 , Viola Laghi 1,2 , Elena Natoli 1,2 , Johnny Ma 1,2 , Giorgio Coco 1,2 , Alessandra D'Alterio 1,2 , Milly Buwenge 1 , Sara Tamburini 1,3 , Angelo Mottaran 1,3 , Matteo Droghetti 1,3 , Francesco Chessa 1,3 , Calogero Catanzaro 1,3 , Lorenzo Bianchi 1,3 , Riccardo Schiavina 1,3 , Eugenio Brunocilla 1,3 , Silvia Cammelli 1,2 , Maria Ntreta 2 , Alessio Giuseppe Morganti 1,2 1 Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy. 2 Radiation Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy. 3 Division of Urology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy

Purpose/Objective:

The management of patients with prostate cancer (PCa) treated with radical prostatectomy (RP) and adverse pathology remains a subject of ongoing debate. Both adjuvant radiotherapy (aRT) and early salvage radiotherapy (esRT) have shown comparable biochemical recurrence-free survival (BCR-FS). This analysis aimed to evaluate the feasibility and early oncological outcomes of intensive surveillance and esRT in the postoperative management of PCa patients with an intermediate risk of recurrence after surgery.