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19.09.2023 | Topic Paper

Stereotactic body radiation therapy after radical prostatectomy: current status and future directions

verfasst von: Jennifer Le Guevelou, Nicolas Magne, Felipe Counago, Juan Martin Magsanoc, Matthieu Vermeille, Renaud De Crevoisier, Nicolas Benziane-Ouaritini, Piet Ost, Tamim Niazi, Stéphane Supiot, Paul Sargos

Erschienen in: World Journal of Urology | Ausgabe 11/2023

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Abstract

Purpose

Around 40% of men with intermediate-risk or high-risk prostate cancer will experience a biochemical recurrence after radical prostatectomy (RP). The aim of this review is to describe both toxicity and oncological outcomes following stereotactic body radiation therapy (SBRT) delivered to the prostate bed (PB).

Method

In april 2023, we performed a systematic review of studies published in MEDLINE or ClinicalTrials.gov according to Preferred Reporting Items for Systematic Reviews, using the keywords “stereotactic radiotherapy” AND “postoperative” AND “prostate cancer”.

Results

A total of 14 studies assessing either adjuvant or salvage SBRT to the whole PB or macroscopic local recurrence (MLR) within the PB, and SBRT on radiorecurrent MLR within the PB were included. Doses delivered to either whole PB or MLR between 30 to 40 Gy are associated with a low rate of late grade ≥ 2 genitourinary (GU) toxicity, ranging from 2.2 to 15.1%. Doses above 40 Gy are associated with increased rate of late GU toxicity, raising up to 38%. Oncological outcomes should be interpreted with caution, due to both short follow-up, heterogeneous populations and androgen deprivation therapy (ADT) use.

Conclusion

PB or MLR SBRT delivered at doses up to 40 Gy appears safe with relatively low late severe GU toxicity rates. Caution is needed with dose-escalated RT schedules above 40 Gy. Further prospective trials are eagerly awaited in this disease setting.

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Titel: Stereotactic body radiation therapy after radical prostatectomy: current status and future directions
verfasst von: Jennifer Le Guevelou
Nicolas Magne
Felipe Counago
Juan Martin Magsanoc
Matthieu Vermeille
Renaud De Crevoisier
Nicolas Benziane-Ouaritini
Piet Ost
Tamim Niazi
Stéphane Supiot
Paul Sargos
Publikationsdatum: 19.09.2023
Verlag: Springer Berlin Heidelberg
Erschienen in: World Journal of Urology / Ausgabe 11/2023
Print ISSN: 0724-4983
Elektronische ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-023-04605-7

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Stereotactic body radiation therapy after radical prostatectomy: current status and future directions