Prospective assessment of gastrointestinal and genitourinary toxicity of salvage radiotherapy for patients with prostate-specific antigen relapse or local recurrence after radical prostatectomy.
OBJECTIVE
To assess the acute and late gastrointestinal (GI) and genitourinary (GU) toxicity of salvage radiotherapy (RT).


METHODS
A total of 75 patients with prostate-specific antigen relapse or clinically isolated local recurrence after radical prostatectomy were accrued between 1998 and 2002 for a Phase II study to evaluate the efficacy of salvage RT plus 2-year androgen suppression. Acute and late GI and GU toxicity was prospectively assessed using the National Cancer Institute Expanded Common Toxicity Criteria Version 2. For acute toxicity, prevalence was examined. For late toxicity, cumulative incidences of Grade 2 or higher and Grade 3 toxicity were calculated.


RESULTS
Median age was 67 years at the time of salvage RT. Median time from radical prostatectomy to RT was 36.2 months. Median follow-up was 45.1 months. Seventy-five patients were available for acute toxicity analysis, and 72 for late toxicity. Twelve percent and 40% had preexisting GI and GU dysfunction before RT, respectively. Sixty-eight percent, 21%, and 5% experienced Grade 1, 2, and 3 acute GI or GU toxicity, respectively. Cumulative incidences of Grade 2 or higher late GI and GU toxicity at 36 months were 8.7% and 22.6%, and Grade 3 late GI and GU toxicity, 1.6% and 2.8%, respectively. None had Grade 4 late toxicity. The severity of acute GU toxicity (Grade < 2 vs. >/= 2) was a significant predictor factor for Grade 2 or higher late GU toxicity after adjusting for preexisting GU dysfunction.


CONCLUSIONS
Salvage RT generally was well tolerated. Grade 3 or higher late GI or GU toxicity was uncommon.
Pearse
Maria
M
Department of Radiation Oncology, Auckland Hospital, Auckland, New Zealand.
Choo
Richard
R
Danjoux
Cyril
C
Gardner
Sandra
S
Morton
Gerard
G
Szumacher
Ewa
E
Loblaw
Andrew
A
Cheung
Patrick
P
D000726:Androgen Antagonists / Q000627:therapeutic use; D015415:Biomarkers / Q000097:blood; D003131:Combined Modality Therapy; D005767:Gastrointestinal Diseases / Q000000981:diagnostic imaging* / Q000453:epidemiology; D006801:Humans; D008297:Male; D052801:Male Urogenital Diseases / Q000000981:diagnostic imaging* / Q000453:epidemiology; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D011446:Prospective Studies; D017430:Prostate-Specific Antigen / Q000097:blood*; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D011877:Radionuclide Imaging; D011878:Radiotherapy / Q000009:adverse effects / Q000379:methods*; D012008:Recurrence; D016879:Salvage Therapy / Q000706:statistics & numerical data
D000726:Androgen Antagonists; D015415:Biomarkers; D017430:Prostate-Specific Antigen