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Introduction. Despite advances in the surgical management of prostate cancer (PCa), postoperative recurrence remains a significant clinical challenge. Contemporary approaches to postoperative radiation therapy, including stereotactic body radiation therapy (SBRT), offer promising opportunities to enhance therapeutic efficacy and reduce treatment duration while maintaining an acceptable toxicity profile.
Aim. To evaluate the long-term efficacy and safety of postoperative SBRT directed to the prostate bed (PB) in patients with recurrent PCa following radical prostatectomy (RP).
Materials and Methods. A prospective single-center study enrolled 56 patients with biochemical recurrence of PCa after RP. All patients received SBRT to the PB with a total dose of 35 Gy delivered in five fractions. The median follow-up duration was 38 months. Oncological outcomes, radiation-induced toxicity (assessed using RTOG criteria), and quality of life parameters were evaluated.
Results. Biochemical recurrence occurred in 13 patients (23.2 %), including three cases (5.4 %) of local relapse within the PB. Disease-free survival was maintained in 76.8 % of patients at the final follow-up, with local control achieved in 94.6 % of cases. Acute grade I genitourinary toxicity was observed in 11 patients (19.6 %). Late toxicities included grade I–II genitourinary effects in 25 patients (44.6 %) and grade I–II gastrointestinal effects in five patients (8.9 %). No grade III or higher radiation-related complications were reported. Quality of life measures remained stable compared to baseline values.
Conclusion. Postoperative SBRT targeting the PB provides excellent local control and is well tolerated. This treatment approach represents an effective and safe therapeutic option for patients with recurrent PCa following surgical intervention.
Библиографические ссылки
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