ABSTRACTS OF THE 21st ANNUAL MEETING OF THE ITALIAN ...

More documents

Recommendations

Info

interrupted treatment due to rectal bleeding. Acute toxicity included rectal (G0, 66.2%; G1, 30%; G2, 3.8%) and urinary events (G0, 50%; G1, 22.5%; G2, 27.5%). Late toxicity included rectal (G0, 96.3%; G1, 2.5%; G2, 1.2%) and urinary events (G0, 73.8%; G1, 22.5%; G2, 3.7%). Three-year OS and DFS were 93.5% and 85%, respectively. Five-year OS and DFS were 89.5% and 80.5%, respectively. Discussion and Conclusion: This study showed good results in terms of OS and DFS and also acute and late toxicities were acceptable. Radiotherapy should be considered as an adjuvant treatment for high-risk prostate cancer, especially with positive margins or extracapsular spread, since it is a safe and well-tolerated treatment. 1 Rossi CJ Jr., Joe Hsu IC, Abdel-Wahab M, Arterbery VE, Ciezki JP, Frank SJ, Hahn NM, Moran BJ, Rosenthal SA and Merrick G: ACR appropriateness criteria postradical prostatectomy irradiation in prostate cancer. Am J Clin Oncol 34(1): 92-98, 2011. 2 Vargas C, Kestin LL, Weed DW, Krauss D, Vicini FA and Martinez AA: Improved biochemical outcome with adjuvant radiotherapy after radical prostatectomy for prostate cancer with poor pathologic features. Int J Radiat Oncol Biol Phys 61(3): 714-724, 2005. 144 ADJUVANT RADIOTHERAPY FOR HIGH-RISK PATIENTS AFTER RADICAL PROSTATECTOMY: BENEFITS AND TOXICITY IN OUR EXPERIENCE Girolamo Spagnoletti, Rita Marchese, Grazia Nardella, Vincenzo Oriolo, Giuseppe De Nobili and Giuseppe Bove Radiotherapy Department, Foggia University Hospital, Foggia, Italy Introduction and Aim: Adjuvant radiotherapy has been associated with improved freedom from biochemical failure as compared with radical prostatectomy alone and it is often delivered after surgery for high-risk patients (1, 2). The aim of this study was to assess the benefit and the toxicity of postoperative radiotherapy after surgery for prostate cancer. Patients and Methods: We retrospectively analyzed 80 men treated with adjuvant radiotherapy at the Radiotherapy Department of Foggia from 2006 to 2009. All patients underwent radical prostatectomy and pelvic lymphadenectomy. Median age was 65 years (range: 43-77). Analysis of histologic specimens showed positive margins in 68 patients (85%), extracapsular spread in 50 patients (62.5%) and nodal involvement in 2 patients (2.5%). Median pre-surgery PSA was 9.5 ng/mL and median Gleason score was 7. Hormonal therapy was prescribed for 51 patients (63.7%) of whom 28 (55%) received total androgen deprivation and 23 (45%) received 1886 ANTICANCER RESEARCH 31: 1807-1956 (2011) bicalutamide alone (150 mg/die). Radiotherapy was delivered at a median dose of 68 Gy (2 Gy/die). Disease Free Survival and Overall Survival were calculated and toxicity was assessed with RTOG scale. Results: Median follow-up was 25 months. Median PSA value after adjuvant radiotherapy was 0.07 ng/mL. Radiotherapy treatment was well-tolerated, only one patient interrupted his treatment due to rectal bleeding. Acute toxicity included rectal (G0, 66.2%; G1, 30%; G2, 3.8%) and urinary events (G0, 50%; G1, 22.5%; G2, 27.5%). Late toxicity included rectal (G0, 96.3%; G1, 2.5%; G2, 1.2%) and urinary events (G0, 73.8%; G1, 22.5%; G2, 3.7%). Three-year Overall Survival and Disease Free Survival were 93.5% and 85%. Fiveyear Overall Survival and Disease Free Survival were 89.5% and 80.5%, respectively. Discussion and Conclusion: This study showed good results in terms of OS and DFS and also acute and late toxicities were acceptable. Radiotherapy should be considered as adjuvant treatment for high-risk prostate cancer, especially with positive margins or extracapsular spread, since it is a safe and well-tolerated treatment. 1 Rossi CJ Jr, Joe Hsu IC, Abdel-Wahab M, Arterbery VE, Ciezki JP, Frank SJ, Hahn NM, Moran BJ, Rosenthal SA, Merrick G: ACR appropriateness criteria postradical prostatectomy irradiation in prostate cancer. Am J Clin Oncol 34(1): 92-98, 2011. 2 Vargas C, Kestin LL, Weed DW, Krauss D, Vicini FA, Martinez AA. Improved biochemical outcome with adjuvant radiotherapy after radical prostatectomy for prostate cancer with poor pathologic features. Int J Radiat Oncol Biol Phys 61(3): 714-24, 2005. 145 RADICAL THREE-DIMENSIONAL CONFORMAL RADIATION THERAPY (3D-CRT) FOR OLD PATIENTS WITH LOCALIZED PROSTATE CANCER Girolamo Spagnoletti, Rita Marchese, Anna Maria Leo, Grazia Nardella, Giorgia Cocco and Giuseppe Bove Radiotherapy Department, Foggia University Hospital, Italy Background: Radiation therapy and radical prostatectomy are curative treatment options for patients with localized prostate cancer but surgery is seldom offered to prostate cancer patients beyond the age of 75 years. For these patients, radiation therapy is often the only curative option. Aim: The aim of the present study was to analyze outcome and acute and late side effects of three-dimensional conformal radiation therapy (3D- CRT) for localized prostate cancer in patients aged 75 years and older. Patients and Methods: Ninety-two localized prostate cancer patients aged >75 years were treated at the Radiation Oncology Department in Foggia between January 2007 and December 2009. All patients were affected by intermediate-
Abstracts of the 21st Annual Meeting of the Italian Society of Uro-Oncology (SIUrO), 22-24 June, 2011, Naples, Italy risk disease, with PSA 20 ng/ml or less and tumor category T2c or less. Each patient was scored by using the Cumulative Illness Rating Scale (CIRS) Severity Index comorbidity scale. All men were treated with radical 3D-CRT with or without hormonal therapy. None of the patients received treatment of the pelvic lymphatics. Acute and late side-effects were analyzed according to the toxicity criteria of the Radiation Therapy Oncology Group (RTOG). Overall survival, biochemical recurrence, local recurrence rate and metastasis rate were calculated. Results: The median follow-up was 25 months and the mean age was 78 years (range: 75-89 years). CIRS Severity Index was none (0) for eight patients, mild (1) for 42 patients, moderate (1.01-2) for 29 patients and severe (2.10-3) for 13 patients. Clinical stage was T1 for 65.2% and T2 for 34.8% of patients. The Gleason score sum was 4 for 16.3%, 6 for 30.4%, 7 for 50% and 8 for 3.3% of patients. Thirty-seven percent of men also received hormonal therapy. The mean total prescribed radiotherapy dose was 76.5 Gy, with a range of 72 Gy to 80 Gy, and all patients reached the total prescribed radiotherapy. Acute side-effects observed were urinary toxicity of G1 for 47.8% of patients, G2 for 19.6% and G3 for 6.5%, while rectal toxicity of G1 was observed for 43.5% of patients, G2 for 13% and G3 for 2.2%. Late sideeffects observed were urinary toxicity of G1 for 23.9% and G2 for 3.3%. Late rectal toxicity was G1 for 19.6% of patients and G2 for 6.5% of patients. All patients were still alive at last examination performed in 2010, without metastasis and without local recurrence, and only twelve patients (13%) experienced a biochemical recurrence during follow-up. Conclusion: This analysis showed that 3D-CRT of localized prostate cancer is well tolerated by patients over 75 years old. Despite the short follow-up time, our results demonstrate excellent local control and overall survival, and the benefits of this treatment should be offered to all men with prostate cancer >75 years old. Radiotherapy should be considered as a valid treatment for elderly patients with the same modalities of younger patients, where circumstances and medical conditions permit. 146 SALVAGE RADIOTHERAPY FOR CANCER PATIENTS WITH PSA RELAPSE AFTER RADICAL PROSTATECTOMY: OUR EXPERIENCE Girolamo Spagnoletti, Rita Marchese, Anna Maria Leo, Grazia Nardella, Maria Piserchia and Giuseppe Bove Radiotherapy Department, Foggia University Hospital, Italy Background and Aim: A detectable serum PSA level after radical prostatectomy is referred to as biochemical relapse and it typically occurs months to years before there is clinical evidence of tumor recurrence. Most studies define biochemical relapse as equal to two or three PSA values that are at least 0.2 ng/ml after prostatectomy. Salvage radiotherapy is often considered as a valid option for these patients (1, 2). In this study, we analyzed the benefit and toxicity of salvage radiotherapy after biochemical relapse. Patients and Methods: We retrospectively analyzed the cases of 18 patients who underwent radiotherapy for PSA recurrence after surgery between January 2007 and December 2009 at the Radiation Oncology Department in Foggia. Biochemical relapse was defined as equal to three PSA values that were at least 0.2 ng/ml after radical prostatectomy. At the time of diagnosis of recurrence, the median PSA value was 5 (range 0.5-30.1) ng/ml. Biopsy findings showed local recurrence in ten patients (55.5%). Patients received a median of 72 Gy to the prostate bed without treatment of the regional lymphatics. Recurrencefree survival and overall survival were calculated and toxicity was assessed with RTOG scale. Results: The median followup was 24 months. Radiotherapy treatment was well tolerated and all patients received the prescribed dose. Acute toxicity included rectal (G0, 72.3%; G1, 16.6%; G2, 11.1%) and urinary events (G0, 66.8%; G1, 22.1%; G2, 11.1%). Late toxicity included rectal (G0, 88.9%; G1, 11.1%; G2, 0%) and urinary events (G0, 77.8%; G1, 11.1%; G2, 11.1%). Three-year overall survival and recurrence-free survival were 94.5% and 89.5%, respectively. Five-year overall survival and recurrence free survival were 90% and 84.5%, respectively. Conclusion: Salvage radiotherapy is an effective treatment after radical prostatectomy, and in cases of persistent PSA following surgery for prostate cancer, it can be used with a significant chance of overall survival and recurrence-free survival. Complications are similar to those reported for adjuvant irradiation. 1 Neuhof D, Hentschel T, Bischof M, Sroka-Perez G, Hohenfellner M and Debus J: Long-term results and predictive factors of three-dimensional conformal salvage radiotherapy for biochemical relapse after prostatectomy. Int J Radiat Oncol Biol Phys 67(5): 1411-1417, 2007. 2 Peyromaure M, Allouch M, Eschwege F, Verpillat P, Debré B and Zerbib M: Salvage radiotherapy for biochemical recurrence after radical prostatectomy: a study of 62 patients. Urology 62(3): 503-507, 2003. 147 HYPOFRACTIONATION VERSUS CONVENTIONALLY FRACTIONATED RADIATION THERAPY FOR PROSTATE CANCER: LATE TOXICITY Girolamo Spagnoletti, Rita Marchese, Raffaella Rignanese, Anna Maria Leo, Valentina Verile, Giovanni Plotino and Giuseppe Bove Radiotherapy Department, Foggia University Hospital, Italy 1887
Page 1 and 2:
ANTICANCER RESEARCH 31: 1807-1956 (
Page 3 and 4:
ANTICANCER RESEARCH 31: 1807-1956 (
Page 5 and 6:
1Department of Urology, Ospedale Sa
Page 7 and 8:
Abstracts of the 21st Annual Meetin
Page 9 and 10:
Page 11 and 12:
Page 13 and 14:
Page 15 and 16:
Page 17 and 18:
Page 19 and 20:
Page 21 and 22:
Page 23 and 24:
Page 25 and 26:
Page 27 and 28: Abstracts of the 21st Annual Meetin
Page 77: Abstracts of the 21st Annual Meetin
Page 99 and 100: Table II. Median value 3DCRT V40 V5
Page 129 and 130:
Page 131 and 132:
Page 133 and 134:
Page 135 and 136:
Page 137 and 138:
Page 139 and 140:
Page 141 and 142:
255 ACCURACY OF ENDORECTAL MRI AND
Page 143 and 144:
Page 145 and 146:
Page 147:
Nucciotti R, 35 Oderda M, 37, 38, 1
show all

ABSTRACTS OF THE 21st ANNUAL MEETING OF THE ITALIAN ...

Create successful ePaper yourself

Delete template?

Save as template?