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. 2024 Sep 12;42(1):520.
doi: 10.1007/s00345-024-05205-9.

Systematic review and recommendations for re-irradiation for intraprostatic radiorecurrent prostate cancer after definitive radiation therapy

Anjali L Saripalli  1 , Bhanu Prasad Venkatesulu  1 , Nicholas G Nickols  2   3 , Luca F Valle  2   3 , Matthew M Harkenrider  1 , Amar U Kishan  2 , Abhishek A Solanki  4
Affiliations

Systematic review and recommendations for re-irradiation for intraprostatic radiorecurrent prostate cancer after definitive radiation therapy

Anjali L Saripalli et al. World J Urol. .

Abstract

Purpose: Intraprostatic recurrence (IRR) of prostate cancer after radiation therapy is increasingly identified. Our objective was to review the literature to determine the optimal workup for identifying IRR, the management options, and practical considerations for the delivery of re-irradiation as salvage local therapy.

Methods: We performed a systematic review of available publications and ongoing studies on the topics of IRR, with a focus on salvage re-irradiation.

Results: Work up of biochemically recurrent prostate cancer includes PSMA PET/CT and multiparametric MRI, followed by biopsy to confirm IRR. Management options include continued surveillance, palliative hormonal therapy, and salvage local therapy. Salvage local therapy can be delivered using re-irradiation with low dose rate brachytherapy, high dose rate (HDR) brachytherapy, and stereotactic body radiotherapy (SBRT), as well as non-radiation modalities, such as cryotherapy, high-intensity focused ultrasound, irreversible electroporation and radical prostatectomy. Data demonstrate that HDR brachytherapy and SBRT have similar efficacy compared to the other salvage local therapy modalities, while having more favorable side effect profiles. Recommendations for radiation therapy planning and delivery using HDR and SBRT based on the available literature are discussed.

Conclusion: Salvage re-irradiation is safe and effective and should be considered in patients with IRR.

Keywords: High dose rate brachytherapy; Prostate cancer; Radiorecurrence; Re-irradiation; Salvage local therapy; Stereotactic body radiotherapy.

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References

    1. National Comprehensive Cancer Network (2011) NCCN Clinical practice guidelines in oncology prostate cancer. Version I. 2023:2023
    1. Mahal BA, Butler S, Franco I, Spratt DE, Rebbeck TR, D’Amico AV et al (2019) Use of active surveillance or watchful waiting for low-risk prostate cancer and management trends across risk groups in the United States, 2010–2015. JAMA 321:704–706. https://doi.org/10.1001/jama.2018.19941 - DOI - PubMed - PMC
    1. Jones CU, Hunt D, McGowan DG, Amin MB, Chetner MP, Bruner DW et al (2011) Radiotherapy and short-term androgen deprivation for localized prostate cancer. N Engl J Med 365:107–118. https://doi.org/10.1056/NEJMoa1012348 - DOI - PubMed
    1. Zumsteg ZS, Spratt DE, Romesser PB, Pei X, Zhang Z, Kollmeier M et al (2015) Anatomical patterns of recurrence following biochemical relapse in the dose escalation era of external beam radiotherapy for prostate cancer. J Urol 194:1624–1630. https://doi.org/10.1016/j.juro.2015.06.100 - DOI - PubMed - PMC
    1. Ma TM, Chu F-I, Sandler H, Feng FY, Efstathiou JA, Jones CU et al (2022) Local failure events in prostate cancer treated with radiotherapy: a pooled analysis of 18 randomized trials from the meta-analysis of randomized trials in cancer of the prostate consortium (LEVIATHAN). Eur Urol 82:487–498. https://doi.org/10.1016/j.eururo.2022.07.011 - DOI - PubMed

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