3540 - Reirradiation with SBRT in Radiorecurrent Prostate Cancer ? Impact on Disease Control and Quality of Life Outcomes

02:30pm - 03:45pm PT

Hall F

Screen: 32

POSTER

Presenter(s)

Papaiah Susheela Sridhar, MD, DNB - Apollo Cancer centre,Bangalore, Bangalore, Karnataka

P. S. Sridhar¹, P. Anuradha¹, S. Kundavai², A. Jerrin¹, K. Kallur³, M. Gupta³, and M. Govindarajan¹; ¹Apollo Cancer Centre, Bengaluru, India, ²Apollo Cancer Centre, Chennai, India, ³HealthCare Global Enterprises Ltd, Bengaluru, India

Purpose/Objective(s):

Management of carcinoma prostate includes surgery, radiotherapy and ADT based on risk stratification. Radiotherapy is one of the main treatment modalities for localized prostate cancer. At least 30% of patients still develop recurrence in their lifetime post treatment. In patients with an isolated local recurrence, treatment options include salvage surgery, re-irradiation(SBRT/Brachytherapy) and other local therapies like high-intensity focused ultrasound (HIFU), cryotherapy etc.. Among these options, Re irradiation with SBRT is considered feasible with promising oncological outcomes and relatively lesser side effects. We have analyzed the feasibility of reirradiation with SBRT with a frameless robotic radiosurgery system alone in localized recurrent carcinoma prostate in regards to tumor control and toxicity profiles

Materials/Methods: In our prospective single arm interventional study, we included 13 patients with localized recurrent carcinoma prostate, diagnosed based on biochemical/radiological and pathological parameters treated with SBRT by a frameless robotic radiosurgery system treated from 2014 to 2023.All patients underwent PSMA PET CT and MRI based planning. Recurrent disease in the prostate as seen on PSMA PET avid nodule correlating with enhancing lesion on MRT2 IS contoured as Gross Tumor Volume (GTV REC). Dose delivered was 30 Gy in 5 fractions, on five continuous days. All patients were under regular followup with PSA monitoring, PSMA PET CT/MRI prostate at frequent intervals.

Results: 13 patients were analyzed. Median age was 69 years (range 59 to 74). Median time from initial treatment to recurrence was 72 months (range: 24 to 240). After a median followup of 28 months, local control was 100%. All patients tolerated the treatment with Grade 1/2 toxicities. 4 patients (30%) had progressive disease and started on ADT for the same.

Conclusion: From our study, we conclude that reirradiation with SBRT in radiorecurrent prostate cancer is feasible and effective in providing good local control and best quality of life. SBRT can be considered an effective alternative for ADT in such patients. Larger sample sizes are required to validate the same.