title: Salvage intensity-modulated radiation therapy for locally recurrent prostate cancer after cryotherapy.
abstract: BACKGROUND
  To summarize our results of intensity-modulated radiation therapy (IMRT) for prostate adenocarcinoma after cryotherapy failure.
  
  
  METHODS
  Patients underwent IMRT with curative intent for biochemically recurrent prostate cancer after cryotherapy. Radiation was delivered to a minimum dose of 72 Gy (range, 72-81 Gy). Acute and late treatment-related gastrointestinal and genitourinary effects were scored according to Common Toxicity Criteria version 3.0. Prostate-specific antigen failure was defined by Radiation Therapy Oncology Group-American Society for Therapeutic Radiology and Oncology 2006 consensus definition.
  
  
  RESULTS
  Nine patients were treated from 2008 to 2010. The median follow-up was 31 months (range, 15-40 months). The mean preradiotherapy prostate-specific antigen was 4.3 ng/mL (range, 1.07-15.6 ng/mL). The median elapsed time between cryotherapy and IMRT was 20.5 months (range, 8.5-56.5 months). Biochemical control was achieved in 7 patients. Two patients developed distant metastases shortly after completion of radiotherapy. No patients experienced grade 3 or higher toxicities.
  
  
  CONCLUSIONS
  Our results suggest that high-dose IMRT after cryotherapy failure is well tolerated, without severe morbidity. The results also showed that IMRT can render a significant number of patients biochemically free of disease after initial cryotherapy. High-dose IMRT should be considered as a treatment option for these potentially salvageable cases.
authors.affiliation: Department of Radiation Oncology, Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL 60611, USA. mehee-choi@fsm.northwestern.edu
authors.forename: Mehee
authors.initials: M
authors.lastname: Choi
authors.forename: Choong R
authors.initials: CR
authors.lastname: Kim
authors.forename: Arthur Y
authors.initials: AY
authors.lastname: Hung
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy / Q000532:radiotherapy* / Q000601:surgery; D000368:Aged; D000369:Aged, 80 and over; D003452:Cryosurgery; D041981:Gastrointestinal Tract / Q000528:radiation effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000532:radiotherapy*; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000188:drug therapy / Q000532:radiotherapy* / Q000601:surgery; D011879:Radiotherapy Dosage; D020266:Radiotherapy, Conformal; D050397:Radiotherapy, Intensity-Modulated; D017211:Treatment Failure; D016896:Treatment Outcome; D014566:Urogenital System / Q000528:radiation effects
chemical_list: D017430:Prostate-Specific Antigen