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ORIGINAL RESEARCH article

Front. Oncol.
Sec. Radiation Oncology
Volume 14 - 2024 | doi: 10.3389/fonc.2024.1468248
This article is part of the Research Topic Efficacy and Safety of SRS/SBRT in Oligometastatic Disease Management View all 3 articles

Nodal radiotherapy for prostate adenocarcinoma recurrence: predictive factors for efficacy

Provisionally accepted
Anna GUEIDERIKH Anna GUEIDERIKH 1*Jérémy Baude Jérémy Baude 2David Baron David Baron 3Renaud Schiappa Renaud Schiappa 4,5Sandrine Katsahian Sandrine Katsahian 6,7,8,9Damien Moreau Damien Moreau 1Marc Laurans Marc Laurans 1Jean-Emmanuel Bibault Jean-Emmanuel Bibault 1Sarah Kreps Sarah Kreps 1Pierre-yves Bondiau Pierre-yves Bondiau 3Magali Quivrin Magali Quivrin 2Alexis Lépinoy Alexis Lépinoy 10David Pasquier David Pasquier 11Jean-Michel Hannoun-Levi Jean-Michel Hannoun-Levi 3Philippe Giraud Philippe Giraud 1
  • 1 Radiation Oncology Department, Hôpital Européen Georges-Pompidou, Paris, France
  • 2 Radiation Oncology Department, Centre Georges François Leclerc, Dijon, Burgundy, France
  • 3 Radiation Oncology Department, Centre Antoine Lacassagne, Nice, Provence-Alpes-Côte d'Azur, France
  • 4 Epidemiology, Biostatistic and Health Data Department, Centre Antoine Lacassagne, Nice, Provence-Alpes-Côte d'Azur, France
  • 5 Université Côte d'Azur, Nice, Provence-Alpes-Côte d'Azur, France
  • 6 Université Paris Cité, Paris, Île-de-France, France
  • 7 Unité de Recherche Clinique, APHP.Centre, Hôpital Européen Georges-Pompidou, Paris, France
  • 8 INSERM CIC1418 CIC Hôpital Européen Georges Pompidou, Paris, Île-de-France, France
  • 9 équipe 22, INSERM UMRS1138 Laboratoire d'Immunologie et Cancérologie Intégratives, Paris, France
  • 10 Institut de Cancérologie de Bourgogne, Dijon, France
  • 11 Radiation Oncology Department, Centre Oscar Lambret, Lille, Nord-Pas-de-Calais, France

The final, formatted version of the article will be published soon.

    Background: Nodes are the second site for prostate cancer recurrence. Whole pelvic radiotherapy (WPRT) has shown superiority over nodal stereotaxic radiotherapy (SBRT) in two retrospective cohorts. We aimed at comparing both modalities and to assess factors associated with treatment outcomes.Materials and Methods: This retrospective multicentric cohort study included patients from five institutions spanning from 2010 to 2022. Patients had a history of prostatic adenocarcinoma classified as N0M0 at diagnosis with a first nodal only pelvic castration-sensitive recurrence. Failurefree survival (FFS) was defined as time from the end of RT to the first failure event -biochemical or imaging recurrence, or death.Results: 147 patients (pts) were analyzed, mainly treated for a recurrence after initial postatectomy (87%), with 64 (43.5%) undergoing SBRT and 83 (56.5%) undergoing WPRT. SBRT was chosen mainly for dosimetric constraints (67%) and was associated with a lower rate of concomitant androgen deprivation therapy (ADT) prescription. With a median follow-up of 68 months (IQR= 51), FFS was significantly lower in the SBRT group (p <0.0001. In multivariable analysis, WPRT and ADT were associated with a longer FFS. Factors associated with a longer FFS after SBRT included associated ADT, lower PSA levels, a PSA doubling time >6 months and a Gleason score <8. SBRT was associated with a lower rate of genitourinary and gastrointestinal grade ≥2 complications.Discussion:For an isolated pelvic nodal prostate cancer recurrence, SBRT is associated with a shorter FFS compared to WPRT. SBRT is often more convenient for patients, and leaves further pelvic salvage options available, so can be explored as an option with well-informed patients.

    Keywords: Nodal recurrence, Prostate adenocarcinoma, Whole pelvic radiation therapy, SBRT (stereotactic body radiation therapy), Androgen deprivation therapy (ADT), PSA doubling time

    Received: 21 Jul 2024; Accepted: 01 Oct 2024.

    Copyright: © 2024 GUEIDERIKH, Baude, Baron, Schiappa, Katsahian, Moreau, Laurans, Bibault, Kreps, Bondiau, Quivrin, Lépinoy, Pasquier, Hannoun-Levi and Giraud. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Anna GUEIDERIKH, Radiation Oncology Department, Hôpital Européen Georges-Pompidou, Paris, 75015, France

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.