PMID- 30825495
OWN - NLM
STAT- MEDLINE
DCOM- 20191128
LR  - 20191128
IS  - 1879-355X (Electronic)
IS  - 0360-3016 (Linking)
VI  - 104
IP  - 3
DP  - 2019 Jul 1
TI  - Reirradiation of Locally Recurrent Prostate Cancer With Volumetric Modulated Arc 
      Therapy.
PG  - 614-621
LID - S0360-3016(19)30285-8 [pii]
LID - 10.1016/j.ijrobp.2019.02.041 [doi]
AB  - PURPOSE: This study explores the efficacy and safety of reirradiation with modern 
      radiation therapy techniques in patients previously irradiated for prostate 
      cancer and affected by local relapse of disease. METHODS AND MATERIALS: Patients 
      affected by previously irradiated prostate cancer were enrolled in this 
      reirradiation study if they had a biochemical relapse and a (11)C-choline 
      positron emission tomography scan revealing the presence of a local recurrence of 
      disease. Reirradiation consisted of a stereotactic treatment delivered by image 
      guided radiation therapy-volumetric modulated arc therapy with flattening 
      filter-free technology in 5 daily fractions. RESULTS: Twenty-three patients 
      underwent reirradiation to the prostate, prostatic bed, or prostate and local 
      recurrence. Re-treatment consisted of a median total dose of 25 Gy in 5 
      fractions. A biochemical response was observed in all cases. Acute toxicity was 
      mainly genitourinary (GU) grade 1 to 2 (n = 13; 56.5%). One patient (4.3%) had 
      grade 3 hematuria. A grade 1 GU late toxicity was registered in 4 patients 
      (17.4%) and grade 3 in 1 patient (4.3%, urethral obstruction). Gastrointestinal 
      toxicity was negligible. Regression analysis showed that only a short elapsed 
      time in months from primary radiation therapy was significantly correlated with 
      acute GU toxicity. After a median follow-up of 33 months (range, 5-58 months), 
      the median biochemical recurrence-free survival was 19 months, and the 2-year 
      biochemical recurrence-free survival (BRFS) was 41.7%. Median local control was 
      30 months; the 2-year local control rate was 58.1%. CONCLUSIONS: Reirradiation of 
      patients with prostate cancer who underwent previous radiation therapy is a 
      valuable option that can be safely considered to delay the beginning of hormonal 
      treatment.
CI  - Copyright (c) 2019 Elsevier Inc. All rights reserved.
FAU - D'Agostino, Giuseppe Roberto
AU  - D'Agostino GR
AD  - Department of Radiotherapy and Radiosurgery, Humanitas Clinical and Research 
      Center, Humanitas University, Milan, Italy. Electronic address: 
      giuseppe.dagostino@humanitas.it.
FAU - Di Brina, Lucia
AU  - Di Brina L
AD  - Department of Radiotherapy and Radiosurgery, Humanitas Clinical and Research 
      Center, Humanitas University, Milan, Italy.
FAU - Mancosu, Pietro
AU  - Mancosu P
AD  - Department of Radiotherapy and Radiosurgery, Humanitas Clinical and Research 
      Center, Humanitas University, Milan, Italy.
FAU - Franzese, Ciro
AU  - Franzese C
AD  - Department of Radiotherapy and Radiosurgery, Humanitas Clinical and Research 
      Center, Humanitas University, Milan, Italy.
FAU - Iftode, Cristina
AU  - Iftode C
AD  - Department of Radiotherapy and Radiosurgery, Humanitas Clinical and Research 
      Center, Humanitas University, Milan, Italy.
FAU - Franceschini, Davide
AU  - Franceschini D
AD  - Department of Radiotherapy and Radiosurgery, Humanitas Clinical and Research 
      Center, Humanitas University, Milan, Italy.
FAU - Clerici, Elena
AU  - Clerici E
AD  - Department of Radiotherapy and Radiosurgery, Humanitas Clinical and Research 
      Center, Humanitas University, Milan, Italy.
FAU - Tozzi, Angelo
AU  - Tozzi A
AD  - Department of Radiotherapy and Radiosurgery, Humanitas Clinical and Research 
      Center, Humanitas University, Milan, Italy.
FAU - Navarria, Pierina
AU  - Navarria P
AD  - Department of Radiotherapy and Radiosurgery, Humanitas Clinical and Research 
      Center, Humanitas University, Milan, Italy.
FAU - Scorsetti, Marta
AU  - Scorsetti M
AD  - Department of Radiotherapy and Radiosurgery, Humanitas Clinical and Research 
      Center, Humanitas University, Milan, Italy; Department of Biomedical Sciences, 
      Humanitas University, Milan, Italy.
LA  - eng
PT  - Journal Article
DEP - 20190227
PL  - United States
TA  - Int J Radiat Oncol Biol Phys
JT  - International journal of radiation oncology, biology, physics
JID - 7603616
RN  - EC 3.4.21.77 (Prostate-Specific Antigen)
RN  - N91BDP6H0X (Choline)
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Choline
MH  - Dose Fractionation, Radiation
MH  - Feasibility Studies
MH  - Humans
MH  - Male
MH  - Neoplasm Recurrence, Local/blood/diagnostic imaging/*radiotherapy
MH  - Positron-Emission Tomography
MH  - Progression-Free Survival
MH  - Prostate/radiation effects
MH  - Prostate-Specific Antigen/blood
MH  - Prostatic Neoplasms/blood/diagnostic imaging/*radiotherapy
MH  - Radiosurgery/adverse effects/*methods
MH  - Radiotherapy, Image-Guided/methods
MH  - Radiotherapy, Intensity-Modulated/adverse effects/*methods
MH  - Re-Irradiation/adverse effects/*methods
MH  - Regression Analysis
MH  - Retrospective Studies
MH  - Urination Disorders/etiology
EDAT- 2019/03/03 06:00
MHDA- 2019/11/30 06:00
CRDT- 2019/03/03 06:00
PHST- 2018/09/19 00:00 [received]
PHST- 2019/02/08 00:00 [revised]
PHST- 2019/02/21 00:00 [accepted]
PHST- 2019/03/03 06:00 [pubmed]
PHST- 2019/11/30 06:00 [medline]
PHST- 2019/03/03 06:00 [entrez]
AID - S0360-3016(19)30285-8 [pii]
AID - 10.1016/j.ijrobp.2019.02.041 [doi]
PST - ppublish
SO  - Int J Radiat Oncol Biol Phys. 2019 Jul 1;104(3):614-621. doi: 
      10.1016/j.ijrobp.2019.02.041. Epub 2019 Feb 27.