Postoperative Adjuvant and Salvage Radiotherapy in Prostate Cancer Patients with Adverse Prognostic Factors
Objective:
The aim of the study is to evaluate the contribution of postoperative adjuvant radiotherapy (ART) and salvage radiotherapy (SRT) to oncological outcomes and side effects related to treatment in prostate cancer patients with adverse prognostic factors.
Material and Methods:
Between January 2000 and January 2020, 93 patients who diagnosed with prostate cancer and underwent ART or SRT in our clinic after radical prostatectomy (RP) were evaluated retrospectively. Fifty-two patients received ART and 41 patients SRT. Biochemical relapse-free survival (bRFS) and treatment-related acute and late gastrointestinal and genitourinary toxicities were evaluated.
Results:
The median age of the patients in the study was 64 (50-82) years. The median follow-up was 30 months ( 3-234 months) following radiotherapy (RT). ART was applied to 52 patients with adverse pathological features while SRT was applied to 41 patients with a PSA level ≥ 0.2 ng / mL detected during follow-up . bPFS rates at 3 years were detected as 100% in the ART and 97.57% in the SRT arm. Acute and late side effects were found to be similar between two arms. In logistic regression analysis in which the factors predicting the development of acute toxicity were investigated, the risk of developing acute toxicity was found to be higher in patients with lymph node involvement (p = 0.047) and those who underwent whole pelvic RT (WPRT) instead of prostate bed radiotherapy only (PB-RT)( p = 0.002). Statistically significant difference was not found in terms of late toxicity.
Conclusion:
Postoperative radiotherapy improves bPFS in patients with adverse prognostic factors. Postoperative pelvic radiotherapy significantly increases acute gastrointestinal toxicity rates. Advanced treatment techniques such as volumetric arc therapy (VMAT) should be considered in pelvic radiotherapy so as to reduce the incidence of these side effects.
Kötü Prognostik Faktörlü Prostat Kanser Tanılı Hastalarda Postoperatif Adjuvan ve Kurtarma Radyoterapi
Key words: Keywords: Prostate cancer, postoperative radiotherapy, adjuvant radiotherapy, salvage radiotherapy, prognostic factors
Anahtar Kelimeler: Prostat kanseri, postoperatif radyoterapi, adjuvan radyoterapi, kurtarma radyoterapisi, prognostik faktörler
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