Outcomes of post-prostatectomy radiotherapy at a Regional Cancer Centre

Nicholls, Luke, Winter, Amber, Harwood, Ashley, Plank, Ashley, Bagga, Preeti, Wong, Winnie and Khoo, Eric (2017) Outcomes of post-prostatectomy radiotherapy at a Regional Cancer Centre. Journal of Medical Radiation Sciences, 64 4: 259-265. doi:10.1002/jmrs.240

Author Nicholls, Luke
Winter, Amber
Harwood, Ashley
Plank, Ashley
Bagga, Preeti
Wong, Winnie
Khoo, Eric
Title Outcomes of post-prostatectomy radiotherapy at a Regional Cancer Centre
Journal name Journal of Medical Radiation Sciences   Check publisher's open access policy
ISSN 2051-3895
Publication date 2017-08-14
Year available 2017
Sub-type Article (original research)
DOI 10.1002/jmrs.240
Open Access Status DOI
Volume 64
Issue 4
Start page 259
End page 265
Total pages 7
Place of publication Chichester, West Sussex, United Kingdom
Publisher John Wiley & Sons
Language eng
Subject 3614 Radiological and Ultrasound Technology
2741 Radiology Nuclear Medicine and imaging
Abstract Introduction To investigate the efficacy and toxicity of radiation therapy (RT) after radical prostatectomy (RP) for prostate cancer at Radiation Oncology Centres, Toowoomba. Methods The electronic medical records of 130 consecutive patients with histologically proven prostate adenocarcinoma who underwent post-prostatectomy RT between January 2008 and December 2014 were analysed. Primary endpoint was Biochemical Recurrence (BCR) after RT. BCR was defined by PSA > 0.2 ng/mL and BCR endpoints were analysed using Kaplan-Meier methods. The impact of RT technique and the rates of acute and late toxicities are also reported. Toxicities were graded according to Radiation Therapy Oncology Group (RTOG) criteria. Results Median follow-up time after RT (regardless of technique) was 28 months. BCR occurred in 32 of the 126 patients (25%) whose prostate specific antigen (PSA) levels have been monitored post-RT. At 24 and 36 months, 85% and 75% of patients were BCR-free, respectively. Patients with a pre-RT PSA above 0.2 ng/mL had a higher probability of recurrence than patients with values below 0.2 ng/mL (P=0.03). RT technique, pelvic nodal irradiation, androgen deprivation therapy, T staging or surgical margin did not significantly impact BCR results. No patient experienced acute toxicities greater than grade 2. Grade 1 or 2 late gastrointestinal (GI) toxicity occurred in 11% and 1 patient experienced a grade 3 event. 12% of patients developed grade 1 or 2 late genitourinary (GU) toxicity, with evidence of grade 3 severity in only 1 patient. Evidence of a trend in reduction in late GI toxicity with the use of intensity modulated radiation therapy (IMRT) or volumetric modulated arc therapy (VMAT) was apparent but not with late GU toxicity. Conclusion At our regional centre, early RT (PSA < 0.2ng/mL) was associated with significant improvement in BCR-free survival. Rates of toxicity mirror those of landmark trials which suggest no detriment for our regional prostate cancer patients. The use of IMRT/VMAT techniques was associated with a trend towards reduced rates of GI toxicity.
Keyword Prostate cancer
Radiation therapy
Regional cancer centre
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
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Created: Fri, 15 Sep 2017, 15:59:27 EST by Jacky Cribb on behalf of Learning and Research Services (UQ Library)