Salvage radiotherapy after radical prostatectomy: Long-term results of urinary incontinence, toxicity and treatment outcomes

Lisanne F. van Dessel*, Sarah H. M. Reuvers, Chris H. Bangma, Shafak Al-Uwini

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

13 Citations (Scopus)
192 Downloads (Pure)

Abstract

Purpose: For patients with local recurrent disease after radical prostatectomy (35-54%) salvage radiotherapy (SRT) is the treatment of choice. In the post prostatectomy setting, SRT may impose risk at increased toxicity. As data on long-term toxicity, especially on urinary incontinence, are scarce, we report on the long-term treatment outcomes, toxicity and urinary incontinence rates after SRT.

Materials and methods: Patients with biochemically recurrent prostate cancer after radical prostatectomy, who were treated with SRT (3D-CRT) at our institution between 1998 and 2012, were included in this retrospective cohort analysis. Primary endpoint was urinary incontinence rate. Secondary endpoints were acute and late grade >= 2 genitourinary (GU) and gastrointestinal (GI) toxicity rates, biochemical progression-free survival (bPFS), distant metastasis-free survival (DMFS), disease specific survival (DSS), and overall survival (OS).

Results: 244 patients were included. Median follow-up after SRT was 50 months (range: 4-187 months). Before start of SRT 69.7% of patients were continent for urine. After SRT de novo urinary incontinence complaints (grade >= 1) occurred in the respective acute and late phase in 6.1% and 17.6% of patients. Respective acute grade >= 2 GU and GI toxicity was 19.2% and 17.6%. Late grade >= 2 toxicity for GU was 29.9% and for GI was 21.3%, respectively. The respective 5-year bPFS, OS, DSS and DMFS rates were 47.6%, 91.8%, 98.8% and 80.5%.

Conclusions: Experience at our institution with SRT demonstrates that this results in good long-term biochemical control. However, toxicity and urinary incontinence rates were high. (C) 2018 The Authors. Published by Elsevier B.V.

Original languageEnglish
Pages (from-to)26-32
Number of pages7
JournalClinical and Translational Radiation Oncology
Volume11
DOIs
Publication statusPublished - Jun-2018
Externally publishedYes

Keywords

  • Radiotherapy
  • Salvage therapy
  • Toxicity
  • Urinary incontinence
  • Prostatic neoplasms
  • CONVENTIONALLY FRACTIONATED RADIOTHERAPY
  • RADIATION-THERAPY
  • NON-INFERIORITY
  • CANCER
  • ADJUVANT
  • PROGRESSION
  • RECURRENCE
  • ANTIGEN
  • PSA

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