GU Symposium 2021: Dose-Intensified Approach to Salvage Radiotherapy in Biochemically Recurrent Prostate Cancer
Posted: Friday, February 26, 2021
According to the phase IIII randomized SAKK 09/10 trial, presented at the 2021 Genitourinary (GU) Cancers Symposium (Abstract 194), dose-intensified salvage radiotherapy delivered to the prostate bed was not superior to conventional-dose radiotherapy for treating biochemical disease progression following radical prostatectomy. In addition, Daniel M. Aebersold, MD, of Bern University Hospital, Switzerland, and colleagues noted that the dose-intensified treatment was associated with higher rates of late grade 2 or higher gastrointestinal toxicity.
“Results tell us more is not always better,” said Neeraj Agarwal, MD, of Huntsman Cancer Institute, Salt Lake City, in an American Society of Clinical Oncology press release. “In this study of men with recurrence of prostate cancer after surgery, standard dose of radiation was as effective as the higher dose of radiation therapy in controlling the disease and was less toxic.”
In this open-label trial, the authors assigned 350 men with biochemical disease progression after radical prostatectomy to receive conventional (64 Gy in 32 fractions) or dose-intensified (70 Gy in 35 fractions) radiotherapy. In total, 175 men from cancer centers in Switzerland, Germany, and Belgium received the conventional dose, and 175 received the dose-intensified therapy.
At the time of data cutoff, the median follow-up was 6.2 years, and 138 biochemical disease progression events had occurred among the population. The estimated freedom from biochemical disease progression at 6 years was 62.3% for those who received the conventional dose and 61.3% for those who received the dose-intensified therapy. The authors reported no significant differences when comparing clinical progression-free survival, time to hormonal treatment, or overall survival between the patient groups.
For patients who received conventional therapy, 35 experienced late grade 2 genitourinary toxicity, and 13 experienced grade 3 toxicity. Patients who received the dose-intensified therapy had 46 and 7 late grade 2 and 3 genitourinary toxicities, respectively. Those given the dose-intensified treatment experienced more late grade 2 gastrointestinal toxicity than those given conventional treatment but less grade 3 gastrointestinal toxicity.
Disclosure: For full disclosure of the study authors, visit coi.asco.org.
