Session Item

Cryotherapy (CRYO), irreversible electroporation (IRE), or high-intensity focused ultrasound (HIFU), are different treatment options for early-stage adenocarcinoma of the prostate. Failures following this procedure are not infrequently and little data exists regarding salvage radiotherapy. We summarize our experience.

All consecutive ten cases of salvage radiotherapy following cryoablation, IRE or HIFU failure for cancer prostate from 2011 to 2021 were analyzed.Patients were treated with IMRT and received a mean dose of 72.2 Gy (range, 70-76 Gy) to the prostate and seminal vesicles alone. PSA failure was defined by Phoenix consensus definition. Acute and late GI and GU toxicity were graded according to the CTCAE v5 scale.

Patients characteristics are shown in table 1. Mean pre-focal treatment PSA was 9.03 ng/ml (4.7-17). Mean PSA prior to irradiation was 10.61 ng/ml (2.2-26.4). Median interval to RT was 25.95 months. Median follow up was 30.63 months. Biochemical control was achieved in 8 of the 10 patients and one developed nodal relapse. All of them are alive at last follow up. Median time to highest GU and GI toxicity was 4,36 and 11.5 months respectively. The acute and highest late toxicity is summarized in table2. Three patients experienced late grade 3 rectal bleeding needing Argon laser treatment (previous diabetes and hypertension in two of them). Only one patient who did not have erectile dysfunction previously, developed it after radiation therapy.

Table 1: Patients characteristics.

Table 2: Acute and highest late toxicity.

In our experience a high dose IMRT irradiation following CRYO, IRE or HIFU is well tolerated with moderate acute and late toxicity.