Copenhagen, Denmark
Onsite/Online

ESTRO 2022

Session Item

Urology
Poster (digital)
Clinical
Adjuvant radiation therapy after radical prostatectomy
VICTOR DUQUE-SANTANA, Spain
PO-1394

Abstract

Adjuvant radiation therapy after radical prostatectomy
Authors:

VICTOR DUQUE SANTANA1, Jose Domínguez Rullán2, Asunción Hervás Morón3, Fernando López-Campos2, Carmen Vallejo Ocaña2, Mireia Valero Perena4, Margarita Martín Martín2, David Sevillano Martínez5, Juan David Garcia Fuentes5, Sonsoles Sancho García2

1Ramon y Cajal University Hospital, Radiation Oncology , Madrid, Spain; 2Ramon y Cajal University Hospital, Radiation Oncology, Madrid, Spain; 3Ramon y Cajal University Hospital, Radiation Oncology, Madrid , Spain; 4Ramon y Cajal University Hospital, Radiation Oncology, MAdrid, Spain; 5Ramon y Cajal University Hospital, Physics, Madrid, Spain

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Purpose or Objective

The purpose of the study is to analyze the results of adjuvant radiotherapy after radical prostatectomy and to determine prognostic factors of biochemical relapse free survival (BRFS).

Material and Methods

120 consecutive patients were treated between 1997 and 2014 at our institution. Overall survival and biochemical relapse free survival were calculated using Kaplan-Meier method and the COX proportional hazard test was used to assess differences between groups.  We also analyse the possible associations between the quantitative and qualitative variables by Student's T analysis or the chi-squared test (x2).

Results

Mean age at diagnosis was 65 years (42-80). 51 (42.5%) patients were Gleason 6, 56 (46.7%) patients were Gleason 7 and 13 (9.7%) patients were Gleason ≥8.  55 (45.9%) patients underwent radical prostatectomy combined with pelvic lymphadenectomy and 65 (54.1%) patients underwent radical prostatectomy without pelvic lymphadenectomy.  12 (10%) patients had negative surgical margins, 104 (86.6%) patients had positive surgical margins and 4 (3.3%) close surgical margins.  15 (12.5%) patients were treated with neoadjuvant hormone therapy. 60 (50%) patients were pT2, 53 (44.2%) were pT3 and 7 (5.8%) were pT4. Adjuvant RT was performed in all patients. 23 (19.2%) patients received <70Gy and 97 (80.8%) received 70Gy. 19 (16.1%) patients experienced biochemical relapse.  8 (6.7%) developed local relapse. 14 (11.7%) developed nodal relapse. 11 (9.2%) developed metastatic relapse. After a median follow-up of 114 months (10-239 months). Overall survival at 5 and 10 years were 94.0% and 83.1%, respectively and BRFS at 5 and 10 years was 85.4% vs. 83.2%%, respectively.  Gleason at diagnosis was a  significant prognosis factor of BRFS (p=0.003) and radiotherapy at dose > 70Gy was not related with a better BRFS (p=0.830)

Conclusion

Postoperative radiation therapy provides excellent long-term overall survival with good biochemical relapse free survival.  Dose escalated radiotherapy up to >70Gy doesn´t improve the biochemical relapse free survival in these patients.