ESTRO 36 Abstract Book

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S88 ESTRO 36 2017
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In all treatments constraints to rectum, bladder and
urethra were met. Average dose to the treatment volume
was D95: 18.9Gy (SD 2.4Gy). On average 9.4 catheters
(range 6-13) were used. Treatment volume was on average
7.4cc (SD2.9cc). With a median follow-up of 6 months
(range 1-24 months) a biochemical recurrence according
to Phoenix criteria (rise of > 2 ng/mL) had occurred in 1
of 17 patients. There was one patient with late grade 3
urinary incontinence toxicity.
Conclusion
Focal salvage treatment for local recurrence after primary
external beam radiotherapy or brachytherapy is an
effective treatment modality with regards to acute
toxicity. Whether this treatment option might lead to cure
or successfully postpone ADT with acceptable long term
toxicity needs further investigation.
OC-0174 Salvage LDR-brachytherapy for recurrent
prostate cancer: results from a single institution
S. Magrini1, F. Barbera1
1 Spedali Civili di Brescia, Department of Radiation
Oncology "Istituto del Radio", Brescia, Italy
Purpose or Objective
To evaluate the results of whole gland salvage
brachytherapy (SBT) after primary external beam
radiotherapy in terms of toxicity/QoL and efficacy.
Material and Methods
We retrospectively analyzed the clinical data of 19
patients consecutively treated with SBT at our Institution
from June 2012 through November 2015. Local
recurrences were identified with 11C-Choline PET/CT and
MRI after biochemical recurrence according to Phoenix
criteria. The prescription dose was 130Gy-LDR-BT to the
whole prostate gland. Acute and late toxicities were
graded with the CTCAE-4.0 scoring system. Data from IPSS
(International Prostatic Symptoms Score) and IIEF
(International Index of Erectile Function) questionnaires
at baseline and at 6, 12 and 24 months after SBT were also
reported (higher IPSS and lower IIEF indicate
deterioration). Univariate analysis was done to identify
predictors of biochemical control and toxicities.
Results
Median follow up after SBT was 24 months. Observed
severe late toxicities were as follows: 2/19 G3 cystitis
(10,2%) and 1/19 G4 proctitis (5,3%). Median IPSS scores
pre-SBT and after 6,12,24 months were respectively
4,11,12 and 5. Median IIEF score pre-SBT and after 6,12,24
months were respectively 5,2,4 and 4. At the time of
analysis 2/19 patients showed biochemical relapse (3-
years-FFBF 85,2%). At univariate analysis only interval to
relapse after primary EBRT < 70 months (p=0,05) and PSA
reduction between pre-and post SBT level > 80% (p=0,008)
were significantly related to further biochemical failure.
No statistically significant correlations were found
between IPSS and IIEF score before SBRT and post
treatment toxicity.
Conclusion
SBT for recurrent prostate cancer after primary EBRT
seems to be a feasible treatment for selected patients.
The severity of the observed toxicities shows a peak after
6 months/1 year after local re-treatment and then
decreases. Early FFBF rates are good. These preliminary
results suggest further accrual of patients and the
collection of longer term data.
OC-0175 Salvage HDR-BT in prostate local recurrence
after radiation therapy: Retrospective analysis
C. De la Pinta 1, T. Muñoz1, C. Vallejo1, S. Sancho1, F.
López1, M. Martin1 , A. Hervás1
1 Hospital Ramon y Cajal, Radiation Oncology, Madrid,
Spain
Purpose or Objective
The aim of this study was to evaluate the acute and late
toxicities and biochemical disease-free survival and
overall survival after high-dose-rate brachytherapy as a
salvage modality for locally recurrent prostate
radiotherapy failure.
Material and Methods
Between 2007 and 2014, we retrospectively analyzed 20
consecutively patients. Median age of first treatment was
62 years (range 51-73). The majority of the patients in
this study (65%) were low risk. 5p received hormonal
blockade. 11p received treatment with low-dose-rate
brachytherapy (LDR-BT) and 9p received treatment with
external beam radiotherapy with median dose of 75Gy (70-
78Gy). Time to biochemical recurrence was 62 months
(range 14-119). Median presalvage PSA was 3.72 (range
1,83-12,29). After biochemical relapse, we confirm local
recurrence with biopsy. Patients received high-dose-rate
brachytherapy (HDR-BT). The schedule was three
implantations, every two weeks, with 10,5Gy per implant.
By the time of salvage BT, only 1p received ADT. Acute
and late genitourinary and gastrointestinal toxicities were
graded using Common Terminology Criteria for Adverse
Events (CTCv4.0). Overall survival (OS) and biochemical
(bDFS) control were calculated using Kaplan-Meier
method.
Results
After first treatment, acute toxicities consisted of
genitourinary toxicities grade 1 (3p) and grade 3 (1p). Not
late gastrointestinal toxicities.
After HDR-BT, acute toxicities consisted of genitourinary
grade 1 (4p), grade 2 (5p) and grade 3 (3p),
gastrointestinal toxicities grade 1 (3p) and grade 2 (4p)
and impotence in 4p. Not acute toxicities grade 4 were
reported.
Late toxicities consisted of genitourinary grade 3 were
observed in 2p. Not grade 4 complications.
With a median follow-up after salvage HDR-BT of 47
months (range 11-112 months), local control was achieved
on PSA levels in all patients.
Among 20 patients studied, 1 lost follow-up and he was
excluded from the survival analysis.
Using Kaplan-Meier analysis the 2-year and 5-year OS were
100% and 84,2%, respectively. The 2-year and 5-year
biochemical disease-free survival (bDFS) were 85% and
81%, respectively.
Conclusion
Prostate BT is an effective salvage modality in some
selected prostate local recurrence patients after radiation
therapy.
HDR-BT is a good choice to deliver high-dose radiation in
prostate recurrence tumors after external beam
radiotherapy or LDR-BT. This treatment offers adequate
locoregional control with acceptable range of
complications.
OC-0176 Identifying Patients Who Benefit the Most
from Salvage HDR Brachytherapy
G. Valdes1, A.J. Chang1, O. Kenton1, A. Cunha1, T.D.
Solberg1, H. I-Chow1
1University of Californ ia UCSF, Radiation Oncology, San
Francisco CA, U SA
Purpose or Objective
To use mac hine learning to better identify patients that
could benefit from prostate salvage HDRB (HDR
brachytherapy).
Material and Methods
Data was analyzed for 52 consecutively accrued patients
that underwent salvage HDRB between 1998 and 2009 for
locally recurrent prostate cancer following previous
definitive radiation therapy at the University of California,
San Francisco (UCSF). All patients were treated with 36
Gy in 6 fractions after pathologic confirmation of locally
recurrent disease without evidence of metastatic
disease. Determination of biochemical failure after