Purpose/Objective(s)
To analyze the efficacy and toxicity of high-dose salvage intensity-modulated radiotherapy (IMRT) in patients with tumor pelvic recurrence detected by 3T multiparametric magnetic resonance imaging (mpMRI).
Materials/Methods
Between 2009 and 2014, 55 consecutive patients with biochemical recurrence of prostate cancer after radical prostatectomy who were considered for salvage IMRT were included. mpMRI was carried out in all patients before treatment. Salvage IMRT doses were escalated on macroscopic recurrence detected by mpMRI. Biochemical failure after IMRT was defined using PSA nadir plus 0.2 ng/mL definition. Treatment-related complications were evaluated using Common Terminology Criteria for Adverse Events (CTCAE v4.03).
Results
mpMRI was positive in 19/55 (34.5%) patients. Local recurrence and pelvic lymph node and bone metastases were found in 13, 4 and 2 patients respectively. Median pre-IMRT PSA was 0.4 ng/mL (interquartile range 0.30–1.93 ng/mL). Patients with a positive mpMRI showed PSA level significantly higher compared to those with a negative mpMRI (0.4 [0.4] vs 2.2 [4.1] ng/mL, p=0.003). Median doses of IMRT in patients with negative and positive mpMRI ...