title: Stereotactic body radiation therapy salvage reirradiation of radiorecurrent prostatic carcinoma relapsed in the prostatic bed.
abstract: A 67-year-old man presented with a slow increase of prostate-specific antigen value after radical prostatectomy and postoperative radiotherapy for prostate cancer. The patient had received 3D conformal radiotherapy to a total dose of 66 Gy in 33 fractions of 2 Gy each on the prostatic bed. Three years later, a macroscopic local failure was diagnosed at the apical region. The patient could not receive androgenic deprivation therapy or other types of treatment owing to comorbid conditions. Thus, stereotactic body radiation therapy with helical image-guided tomotherapy was administered. The total dose was 30 Gy in 5 consecutive fractions of 6 Gy each to the site of the local failure. The treatment was preceded by a transperineal-guided injection of a self-absorbable hydrogel into the prostatic bed, between rectum and bladder, in order to preserve the rectal wall, which already had received significant doses from the first radiation course. Radiation therapy was well-tolerated. After a follow-up period of 6 months, the patient remains healthy, and there has been no further evidence of metastatic spread or recurrence.
authors.affiliation: Department of Radiotherapy, Azienda Ospedaliera S. Camillo-Forlanini, Rome - Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Arcangeli
authors.forename: Pasquale
authors.initials: P
authors.lastname: Gambardella
authors.forename: Linda
authors.initials: L
authors.lastname: Agolli
authors.forename: Alessia
authors.initials: A
authors.lastname: Monaco
authors.forename: Jessica
authors.initials: J
authors.lastname: Dognini
authors.forename: Giovanni
authors.initials: G
authors.lastname: Regine
authors.forename: Vittorio
authors.initials: V
authors.lastname: Donato
mesh_terms: D000368:Aged; D014408:Biomarkers, Tumor / Q000097:blood; D019583:Dose Fractionation, Radiation; D006801:Humans; D020136:Hydrogel, Polyethylene Glycol Dimethacrylate / Q000008:administration & dosage; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000097:blood / Q000532:radiotherapy*; D017430:Prostate-Specific Antigen / Q000097:blood; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000097:blood / Q000532:radiotherapy* / Q000601:surgery; D011832:Radiation Injuries / Q000517:prevention & control; D011837:Radiation-Protective Agents / Q000008:administration & dosage; D016634:Radiosurgery; D018714:Radiotherapy, Adjuvant; D050397:Radiotherapy, Intensity-Modulated; D012007:Rectum / Q000528:radiation effects; D019233:Retreatment / Q000379:methods; D016879:Salvage Therapy / Q000379:methods*; D017211:Treatment Failure; D016896:Treatment Outcome
chemical_list: D014408:Biomarkers, Tumor; D011837:Radiation-Protective Agents; D020136:Hydrogel, Polyethylene Glycol Dimethacrylate; D017430:Prostate-Specific Antigen