covid
Buscar en
Revista Colombiana de Cancerología
Toda la web
Inicio Revista Colombiana de Cancerología Radioterapia de salvamento para pacientes con cáncer de próstata: experiencia ...
Journal Information
Vol. 16. Issue 3.
Pages 145-153 (January 2012)
Share
Share
Download PDF
More article options
Vol. 16. Issue 3.
Pages 145-153 (January 2012)
Full text access
Radioterapia de salvamento para pacientes con cáncer de próstata: experiencia en el Instituto Nacional de Cancerología
Salvage Radiotherapy for Prostate-Specific Antigen Relapse after Radical Prostatectomy for Prostate Cancer: Experience at the Instituto Nacional de Cancerología
Visits
6287
Rosalba Ospino
Corresponding author
rospino@cancer.gov.co
rosalba_ospino@hotmail.com

Correspondencia Rosalba Ospino, Grupo de Radioterapia, Instituto Nacional de Cancerología. Av. 1.a No. 9-85. Bogotá, D. C., Colombia. Tel.:éfono: (57-1) 334 1997. Correos electrónicos.
, Juan Galvis, Jorge Rugeles, Angélica Mojica, José Esguerra
Grupo de Radioterapia, Instituto Nacional de Cancerología, Bogotá, D. C., Colombia
This item has received
Article information
Resumen
Objetivo

describir la experiencia con radioterapia de salvamento en pacientes que presentaron recaída bioquímica, posterior a una prostatectomía radical, en el Instituto Nacional de Cancerología (INC).

Métodos

estudio observacional retrospectivo tipo serie de casos. Se recolectaron los casos atendidos entre 2003 y 2007. Se describió la información mediante estadística descriptiva, empleando frecuencias relativas, así como medidas de tendencia central y de dispersión. Se describió la supervivencia libre de enfermedad.

Resultados

un total de 40 pacientes que recibieron radioterapia de salvamento por recaída bioquímica fueron incluidos. La recaída posprostatectomía se presentó antes de dos años en el 65% de los pacientes. La mediana de PSA prerradioterapia en el presente estudio fue de 0,9ng/ml. El 87,5% de los pacientes fueron tratados con radioterapia conformacional 3D. El 97,5% de los pacientes recibieron una dosis total de 66 Gy. La supervivencia libre de enfermedad según la clasificación de riesgo de la enfermedad fue de 2,29 años, con una mediana de seguimiento de 28,5 meses. Dos pacientes presentaron recaída bioquímica posterior a la radioterapia de salvamento.

Conclusiones

la radioterapia de salvamento se muestra como una intervención apropiada en pacientes con cáncer de próstata que presentaron recaída bioquímica después de prostatectomía radical; el 94% de los pacientes tratados con radioterapia de rescate en el INC entre 2003 y 2007 están libres de recaída.

Palabras clave:
Neoplasias de la próstata
radioterapia
prostatectomía
antígeno prostático específico
Abstract
Objective

To describe a National Cancer Institute (NCI) study on rescue radiotherapy carried out among patients who had biochemical relapse following radical prostatectomy.

Methods

A retrospective, observational study was performed on cases treated from 2003 to 2007; descriptive statistics, using relative frequency as well as measures of central tendency and dispersion, were used to analyze information. Disease free survival was described.

Results

A total of 40 patients who underwent rescue radiotherapy for biochemical relapse were included in the study. Post-prostatectomy relapse occurred within 2 years in 65% of patients. Median pre-radiotherapy PSA was 0.9ng/ml. 3D conformational radiotherapy was used to treat 87.5% of cases; 97.5% of patients received a total dose of 66 Gy. In accordance with disease risk classification, disease free survival was 2.29 years, with 28.5 months median follow-up. Two patients had biochemical relapse following rescue radiotherapy.

Conclusions

Rescue radiotherapy has been shown to be an appropriate intervention for prostate cancer patients with biochemical relapse following radical prostatectomy; 94% of patients treated with rescue radiotherapy at the NCI from 2003 to 2007 are relapse free.

Key words:
Prostatic neoplasms
brachytherapy
prostatectomy
prostate-specific antigen
Full text is only aviable in PDF
Referencias
[1.]
D.F. Penson, J.M. Chan.
Pros tate cancer.
J Urol, 177 (2007), pp. 2020-2029
[2.]
J.D. Forman, K. Meetze, E. Pontes, et al.
Therapeutic irradiation for patients with an elevated postprostatectomy prostate specific antigen level.
J Urol, 158 (1997), pp. 1436-1439
[3.]
L.E. Lowes, M. Lock, G. Rodríguez, et al.
Circulating tumour cells in prostate cancer patients receiving salvage radiotherapy.
Clin Transl Oncol, 14 (2012), pp. 150-156
[4.]
M. Han, A.W. Partin, C.R. Pound, et al.
Long-term biochemical disease-free and cancer-specific survival following anatomic radical retropubic prostatectomy. The 15- year Johns Hopkins experience.
Urol Clin North Am, 28 (2001), pp. 555-565
[5.]
J.F. Ward, J.W. Moul.
Rising prostate-specific antigen after primary prostate cancer therapy.
Nat Clin Pract Urol, 2 (2005), pp. 174-182
[6.]
C.R. Pound, A.W. Partin, M.A. Eisenberger, et al.
Natural history of progression after PSA elevation following radical prostatectomy.
JAMA, 281 (1999), pp. 1591-1597
[7.]
M. Sia, T. Pickles, G. Morton, et al.
Salvage radiotherapy following biochemical relapse after radical prostatectomy: proceedings of the Genito-Urinary Radiation Oncologists of Canada consensus meeting.
Can Urol Assoc J, 2 (2008), pp. 500-507
[8.]
A.V. D’Amico, J.W. Moul, P.R. Carroll, et al.
Surrogate end point for prostate cancer-specific mortality after radical prostatectomy or radiation therapy.
J Natl Cancer Inst, 95 (2003), pp. 1376-1383
[9.]
S.G. Roberts, M.L. Blute, E.J. Bergstralh, et al.
PSA doubling time as a predictor of clinical progression after biochemical failure following radical prostatectomy for prostate cancer.
Mayo Clin Proc, 76 (2001), pp. 576-581
[10.]
B. Shekarriz, J. Upadhyay, D.P. Wood Jr., et al.
Vesicourethral anastomosis biopsy after radical prostatectomy: predictive value of prostate-specific antigen and pathologic stage.
Urology, 54 (1999), pp. 1044-1048
[11.]
M. Bolla, P.H. van, L. Collette, et al.
Postoperative radiotherapy after radical prostatectomy: a randomised controlled trial (EORTC trial 22911).
[12.]
I.M. Thompson Jr., C.M. Tangen, J. Paradelo, et al.
Adjuvant radiotherapy for pathologically advanced prostate cancer: a randomized clinical trial.
JAMA, 296 (2006), pp. 2329-2335
[13.]
T. Wiegel, S. Störkel, D. Bottke, et al.
Prostate cancer: Phase III study of adjuvant radiotherapy versus wait and see: Impact of pathologic review on analysis.
JCO, 27 (2009), pp. 2924-2930
[14.]
R. Choo, J. Kawakami, R. Siemens, et al.
Two different perspectives in the management of pT3 and/or marginpositive prostate cancer after radical prostatectomy.
[15.]
L. Boccon.
pT3 prostate cancer: the case for salvage (as opposed to adjuvant) radiation therapy.
Eur Urol Supp, 6 (2007), pp. 511-572
[16.]
C. Catton, M. Gospodarowicz, P. Warde, et al.
Adjuvant and salvage radiation therapy after radical prostatectomy for adenocarcinoma of the prostate.
Radiother Oncol, 59 (2001), pp. 51-60
[17.]
D. Neuhof, T. Hentschel, M. Bischof, et al.
Long-term results and predictive factors of three-dimensional conformal salvage radiotherapy for biochemical relapse after prostatectomy.
Int J Radiat Oncol Biol Phys, 67 (2007), pp. 1411-1417
[18.]
A.J. Stephenson, S.F. Shariat, M.J. Zelefsky, et al.
Salvage radiotherapy for recurrent prostate cancer after radical prostatectomy.
JAMA, 291 (2004), pp. 1325-1332
[19.]
A.J. Stephenson, P.T. Scardino, M.W. Kattan, et al.
Predicting the outcome of salvage radiation therapy for recurrent prostate cancer after radical prostatectomy.
J Clin Oncol, 25 (2007), pp. 2035-2041
[20.]
B.J. Trock, M. Han, S.J. Freedland, et al.
Prostate cancerspecific survival following salvage radiotherapy vs observation in men with biochemical recurrence after radical prostatectomy.
JAMA, 299 (2008), pp. 2760-2769
[21.]
J. Michalski, C. Lawton, I. El Naqa, et al.
Development of RTOG consensus guidelines for the definition of the clinical target volume for postoperative conformal radiation therapy for prostate cancer.
Int J Radiat Oncol Biol Phys, 76 (2010), pp. 361-368
[22.]
D.M. Moreira, L.L. Banez, J.C. Presti Jr., et al.
Predictors of secondary treatment following biochemical recurrence after radical prostatectomy: results from the Shared Equal Access Regional Cancer Hospital database.
[23.]
R. Umezawa, H. Ariga, Y. Ogawa, et al.
Impact of pathological tumor stage for salvage radiotherapy after radical prostatectomy in patients with prostate-specific antigen < 1.0ng/ml.
Radiat Oncol, 6 (2011), pp. 150
[24.]
A. Siegmann, D. Bottke, J. Faehndrich, et al.
Salvage radiotherapy after prostatectomy - What is the best time to treat?.
Radiother Oncol, 103 (2012), pp. 239-243
[25.]
T. Martin, F. Wenz, D. Bohmer, et al.
Radiation therapy for prostate cancer in the new S3 guideline. Part 2: postoperative radiation therapy and brachytherapy.
Urologe A, 49 (2010), pp. 216-220
[26.]
F. Wenz, T. Martin, D. Bohmer, et al.
The German S3 guideline prostate cancer: aspects for the radiation oncologist.
Strahlenther Onkol, 186 (2010), pp. 531-534
[27.]
T. Budiharto, C. Perneel, K. Haustermans, et al.
A multiinstitutional analysis comparing adjuvant and salvage radiation therapy for high-risk prostate cancer patients with undetectable PSA after prostatectomy.
Radiother Oncol, 97 (2010), pp. 474-479
[28.]
F. Pinto, T. Prayer-Galetti, M. Gardiman, et al.
Clinical and pathological characteristics of patients presenting with biochemical progression after radical retropubic prostatectomy for pathologically organ-confined prostate cancer.
Urol Int, 76 (2006), pp. 202-208
[29.]
F.K. Chun, M. Graefen, M. Zacharias, et al.
Anatomic radical retropubic prostatectomy-long-term recurrence-free survival rates for localized prostate cancer.
World J Urol, 24 (2006), pp. 273-280
[30.]
P. Swindle, J.A. Eastham, M. Ohori, et al.
Do margins matter?.
The prognostic significance of positive surgical margins in radical prostatectomy specimens. J Urol, 174 (2005), pp. 903-907
[31.]
L. Salomon, A.G. Anastasiadis, P. Antiphon, et al.
Prognostic consequences of the location of positive surgical margins in organ-confined prostate cancer.
Urol Int, 70 (2003), pp. 291-296
[32.]
K.A. Roehl, M. Han, C.G. Ramos, et al.
Cancer progression and survival rates following anatomical radical retropubic prostatectomy in 3,478 consecutive patients: long-term results.
[33.]
E.J. Trabulsi, R.K. Valicenti, A.L. Hanlon, et al.
A multiinstitutional matched-control analysis of adjuvant and salvage postoperative radiation therapy for pT3-4N0 prostate cancer.
Urology, 72 (2008), pp. 1298-1302
[34.]
T. Wiegel, G. Lohm, D. Bottke, et al.
Achieving an undetectable PSA after radiotherapy for biochemical progression after radical prostatectomy is an independent predictor of biochemical outcome--results of a retrospective study.
Int J Radiat Oncol Biol Phys, 73 (2009), pp. 1009-1016
[35.]
J.F. Ward, H. Zincke, E.J. Bergstralh, et al.
Prostate specific antigen doubling time subsequent to radical prostatectomy as a prognosticator of outcome following salvage radiotherapy.
J Urol, 172 (2004), pp. 2244-2248
[36.]
J.J. Coen, A.L. Zietman, H. Thakral, et al.
Radical radiation for localized prostate cancer: local persistence of disease results in a late wave of metastases.
J Clin Oncol, 20 (2002), pp. 3199-3205
[37.]
D.J. Lightner, P.H. Lange, P.K. Reddy, et al.
Prostate specific antigen and local recurrence after radical prostatectomy.
J Urol, 144 (1990), pp. 921-926
[38.]
D. van den Ouden, F.M. Bentvelsen, E.R. Boeve, et al.
Positive margins after radical prostatectomy: correlation with local recurrence and distant progression.
Br J Urol, 72 (1993), pp. 489-494
[39.]
R. Ospino, R. Cendales, C.E. Alonso.
Braquiterapia de alta tasa de dosis en pacientes con cáncer de próstata.
Rev. Colomb. Cancerol, 12 (2008), pp. 30-33
[40.]
J.L. Peterson, S.J. Buskirk, M.G. Heckman, et al.
Late toxicity after postprostatectomy salvage radiation therapy.
Radiother Oncol, 93 (2009), pp. 203-206
[41.]
O.K. Macdonald, S.E. Schild, S.A. Vora, et al.
Radiotherapy for men with isolated increase in serum prostate specific antigen after radical prostatectomy.
Copyright © 2012. Instituto Nacional de Cancerología
Download PDF
Article options