Recently, the British Journal of Urology published a multicenter retrospective study that assessed the efficacy and the possible toxicity of stereotactic body radiotherapy for patients with macroscopic recurrence in the prostate bed following radical prostatectomy. Numerous specialists were involved in the study, including Prof. PierCarlo Gentile, Medical Director at UPMC Hillman Cancer Center at San Pietro FBF (Rome) and Head of Radiotherapy at San Pietro Fatebenefratelli Hospital (Rome), Dr. Federico Bianciardi, Specialist in Radiation Oncology at UPMC Hillman Cancer Center San Pietro FBF, and Dr. Sara A. Allegretta, Specialist in Radiation Oncology at UPMC Hillman Cancer Center at Villa Maria (Mirabello Eclano, Avellino). UPMC Hillman Cancer Centers in Italy are equipped with state-of-the-art and innovative radiation oncology technologies, with of the most advanced linear accelerator available on the market today, and offer innovative radiotherapy and stereotactic radiosurgery and advanced care protocols for cancer patients.
The objective of the study, entitled “Stereotactic radiotherapy for prostate bed recurrence after prostatectomy, a multicentric series” is to assess the effectiveness of radiotherapy to treat macroscopic recurrence in the prostate bed. Due to the limited number of patients in similar studies published in medical literature, the authors selected and included patients from three Italian radiation therapy centers (Milan, Florence, and Rome) to put together a sample of 90 patients suffering from prostate recurrence and treated with stereotactic body radiotherapy.
The surgical approach (radical prostatectomy) is a valid therapeutic option for prostate cancer patients. However, after surgery 30% of patients can develop macroscopic recurrence in the prostate bed, which is often shown by a progressive increase of blood levels of the PSA (prostate-specific antigen) marker, a protein produced by the prostate and found in the blood. High levels can suggest a prostate inflammation or the presence of neoplasias and/or their recurrence. At this point patients are offered salvage radiotherapy that usually last 7 weeks. According to data in literature, this kind of treatment has a 50% risk of local recurrence at 5 years; this is why there is a scientific interest in validating alternative radiotherapy treatments. In recent years, diagnostic imaging has made great progress, broadening and improving its diagnostic potential and allowing to exactly identify the recurrence of the disease. All of the above, combined to the pinpoint accuracy enabled by the rapid evolution of the most advanced stereotactic radiotherapy technology, allows to target only the tissue involved in the recurrence with high doses of radiations in small fractions, hence protecting the healthy surrounding organs.
This study demonstrates how modern radiotherapy techniques allow for excellent local control of recurrences, with low toxicity rates for the patient, and can delay the start of the hormonal therapy, whose efficacy is often limited in time, that is not devoid of side effects, and that can alter the patients’ quality of life.