Salvage radiotherapy after high-intensity focused ultrasound treatment for localized prostate cancer: feasibility, tolerance and efficacy

Authors

  • Thomas Ripert Department of Urology-Andrology, Reims Academic Hospital, Reims, France
  • Younes Bayoud Department of Urology-Andrology, Reims Academic Hospital, Reims, France
  • Rabah Messaoudi Department of Urology-Andrology, Reims Academic Hospital, Reims, France
  • Johann Ménard Department of Urology-Andrology, Reims Academic Hospital, Reims, France
  • Marie-Dominique Azémar Department of Urology-Andrology, Reims Academic Hospital, Reims, France
  • François Duval Department of Urology-Andrology, Reims Academic Hospital, Reims, France
  • Tan Dat Nguyen Department of Radiotherapy, Jean Godinot Institut, Reims, France
  • Frédéric Staerman Department of Urology-Andrology, Reims Academic Hospital, Reims, France

DOI:

https://doi.org/10.5489/cuaj.18

Abstract

Background: The objective of this study is to evaluate the feasibility,tolerance and efficacy of salvage external beam radiotherapy(EBRT) in persistent or recurrent prostate cancer after failed highintensity focused ultrasound (HIFU) therapy.

Methods: We reviewed data on tolerance and oncologic outcomesfor all patients with biopsy-proven locally recurrent or persistentprostate cancer who underwent salvage EBRT in our departmentbetween April 2004 and June 2008. Minimum follow-up for inclusionwas 2 years. Failure with EBRT was defined as biochemicalrelapse (Phoenix definition) or introduction of androgen deprivationtherapy (ADT). Gastrointestinal and urinary toxicity and urinary stressincontinence were scored at 12 and 24 months (Radiation TherapyOncology Group and Ingelman Sundberg rating, respectively).

Results: The mean age of the patients was 68.8 years (range: 60-79).Mean prostate-specific antigen (PSA) before EBRT was 5.57 ng/mL(range: 2.5-14.8). Median follow-up was 36.5 ± 10.9 months(range: 24-54). No patient received adjunctive ADT. The EBRTcourse was well-tolerated and completed by all patients. The meanPSA nadir was 0.62 ng/mL (range: 0.03-2.4) and occurred after amedian of 22 months (range: 12-36). One patient experiencedbiochemical failure and was prescribed ADT 30 months after EBRT.The disease-free survival rate was 83.3% at 36.5 months. Therewas no major EBRT-related toxicity at 12 or 24 months.

Conclusions: Our early clinical results confirm the feasibilityand good tolerance of salvage radiotherapy after HIFU failure.Oncological outcomes were promising. A prospective study withlonger follow-up is needed to identify factors predictive of successfor salvage EBRT therapy after HIFU failure.

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Author Biographies

Thomas Ripert, Department of Urology-Andrology, Reims Academic Hospital, Reims, France

Department of Urology-Andrology, Reims Academic Hospital, Reims, France

Younes Bayoud, Department of Urology-Andrology, Reims Academic Hospital, Reims, France

Department of Urology-Andrology, Reims Academic Hospital, Reims, France

Rabah Messaoudi, Department of Urology-Andrology, Reims Academic Hospital, Reims, France

Department of Urology-Andrology, Reims Academic Hospital, Reims, France

Johann Ménard, Department of Urology-Andrology, Reims Academic Hospital, Reims, France

Department of Urology-Andrology, Reims Academic Hospital, Reims, France

Marie-Dominique Azémar, Department of Urology-Andrology, Reims Academic Hospital, Reims, France

Department of Urology-Andrology, Reims Academic Hospital, Reims, France

François Duval, Department of Urology-Andrology, Reims Academic Hospital, Reims, France

Department of Urology-Andrology, Reims Academic Hospital, Reims, France

Tan Dat Nguyen, Department of Radiotherapy, Jean Godinot Institut, Reims, France

Department of Radiotherapy, Jean Godinot Institut, Reims, France

Frédéric Staerman, Department of Urology-Andrology, Reims Academic Hospital, Reims, France

Department of Urology-Andrology, Reims Academic Hospital, Reims, France

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Published

2012-12-05

How to Cite

Ripert, T., Bayoud, Y., Messaoudi, R., Ménard, J., Azémar, M.-D., Duval, F., Nguyen, T. D., & Staerman, F. (2012). Salvage radiotherapy after high-intensity focused ultrasound treatment for localized prostate cancer: feasibility, tolerance and efficacy. Canadian Urological Association Journal, 6(5). https://doi.org/10.5489/cuaj.18

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Section

Original Research