This was published June 9, 2017, so it's very recent:Salvage robotic SBRT for local prostate cancer recurrence after radiotherapy: preliminary results of the Oscar Lambret Center
It's a retrospective study with a small sample size (25 patients, including a whopping one
G9). The authors present this as directionally favorable, but also provide a number of cautions and limitations. The devil is always in the details.
Here are a couple of them:Prior radiation dose is lower than presently common practiceNevertheless, further follow-up is needed to evaluate late toxicities. Moreover, the median dose previously delivered by EBRT was 73.8 Gy in the Fuller series and 75.6 Gy in ours, corresponding to a lower dose than that currently used for prostate cancer treatment. Increased toxicities may appear for patients previously treated by EBRT with a higher dose.Small sample size, so it's only directionalBecause of the small number of patients included in this study, no prognostic factor could be identified. Currently, no conclusions can be made on available data, but early results are promising. Prospective studies are warranted to identify which patients benefit from local treatment.
Presented for general information. Please read it yourself if you find it interesting, and draw your own conclusions.
Bx: 6/12 pos, G9=5+4 (80%, 60%), 4+5 (2@100%, 80%, 10%), PNI+
cT3a (3T mpMRI: Bilateral EPE, NVB+, SV-, LN-)
Date PSA fPSA
9/12 4.1 15%
3/13 5.2 12% PCA3=31
IGRT by IMRT, 44 done 8/28/13: 50.4 Gy pelvic nodes, 79.2 Gy prostate
ADT2 3 yrs: Lupron/Casodex, ended 3/16
PSA <0.1 : 8/13 - 5/16;
rising - 0.2-8/16, 0.5-12/16, 0.7-3/17, 0.8-5/17, TBD-7/17