Prostate re-irradiation: current concerns and future perspectives. Issue 11 (1st November 2020)

• Record Type: Journal Article
• Authors: Cuccia, Francesco; Mazzola, Rosario; Nicosia, Luca; Giaj-Levra, Niccolò; Figlia, Vanessa; Ricchetti, Francesco; Rigo, Michele; Vitale, Claudio; Corradini, Stefanie; Alongi, Filippo
• Is Part Of: Expert review of anticancer therapy. Volume 20:Issue 11(2020)
• Page Start: 947
• Page End: 956
• Publication Date: 2020-11-01
• Subjects: Prostate cancer -- re-irradiation -- external beam radiotherapy -- stereotactic body radiotherapy -- local relapse; Cancer -- Treatment -- Periodicals; 616.99406
• DOI: 10.1080/14737140.2020.1822742
• Languages: English
• ISSNs: 1473-7140

Abstract

ABSTRACT: Introduction: To date, the optimal management of locally relapsed prostate cancer patients after an initial course of radiotherapy remains a matter of debate. In recent years, local approaches have been proposed as a therapeutic option, which may potentially delay the initiation of hormone therapy. In the case of external beam radiotherapy (EBRT), re-irradiation has been supported by growing evidence in the literature, mostly represented by extreme hypofractionated schedules delivered with stereotactic body radiotherapy (SBRT). Areas covered: We performed a systematic review of the literature using the PICO methodology to explore the available evidence regarding the use of EBRT in the setting of locally relapsed prostate cancer, both in terms of safety, tolerability and preliminary clinical outcomes. Expert opinion: Current literature data report the use of EBRT and particularly of SBRT for the safe and feasible re-treatment of locally recurrent prostate cancer after an initial treatment course of radiotherapy. When extreme hypofractionation is adopted, only occasional grade ≥3 late adverse events are reported. Despite the current lack of high-level evidence and the short follow-up, preliminary clinical outcomes are promising and allow clinicians to hypothesize further prospective studies to evaluate SBRT as an alternative to the early initiation of androgen-deprivation therapy.