title: Salvage image-guided intensity modulated or stereotactic body reirradiation of local recurrence of prostate cancer.
abstract: OBJECTIVE
  To retrospectively evaluate external beam reirradiation (re-EBRT) delivered to the prostate/prostatic bed for local recurrence, after radical or adjuvant/salvage radiotherapy (RT).
  
  
  METHODS
  32 patients received re-EBRT between February 2008 and October 2013. All patients had clinical/radiological local relapse in the prostate or prostatic bed and no distant metastasis. re-EBRT was delivered with selective RT technologies [stereotactic RT including CyberKnife(TM) (Accuray, Sunnyvale, CA); image-guidance and intensity-modulated RT etc.]. Toxicity was evaluated using the Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer criteria. Biochemical control was assessed according to the Phoenix definition (NADIR + 2 ng ml(-1)).
  
  
  RESULTS
  Acute urinary toxicity: G0, 24 patients; G1, 6 patients; G2, 2 patients. Acute rectal toxicity: G0, 28 patients; G1, 2 patients; and G2, 1 patient. Late urinary toxicity (evaluated in 30 cases): G0, 23 patients; G1, 6 patients; G2, 1 patient. Late renal toxicity: G0, 25 patients; G1, 5 patients. A mean follow-up of 21.3 months after re-EBRT showed that 13 patients were free of cancer, 3 were alive with biochemical relapse and 12 patients were alive with clinically evident disease. Four patients had died: two of disease progression and two of other causes.
  
  
  CONCLUSIONS
  re-EBRT using modern technology is a feasible approach for local prostate cancer recurrence offering 2-year tumour control in about half of the patients. Toxicity of re-EBRT is low. Future studies are needed to identify the patients who would benefit most from this treatment.
  
  
  CONCLUSIONS
  Our series, based on experience in one hospital alone, shows that re-EBRT for local relapse of prostate cancer is feasible and offers a 2-year cure in about half of the patients.
authors.affiliation: 1 Department of Radiotherapy, European Institute of Oncology, Milan, Italy.
authors.forename: D
authors.initials: D
authors.lastname: Zerini
authors.affiliation: 1 Department of Radiotherapy, European Institute of Oncology, Milan, Italy.|2 Department of Health Sciences, University of Milan, Milan, Italy.
authors.forename: B A
authors.initials: BA
authors.lastname: Jereczek-Fossa
authors.affiliation: 1 Department of Radiotherapy, European Institute of Oncology, Milan, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Fodor
authors.affiliation: 1 Department of Radiotherapy, European Institute of Oncology, Milan, Italy.|2 Department of Health Sciences, University of Milan, Milan, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Bazzani
authors.affiliation: 1 Department of Radiotherapy, European Institute of Oncology, Milan, Italy.|2 Department of Health Sciences, University of Milan, Milan, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Maucieri
authors.affiliation: 1 Department of Radiotherapy, European Institute of Oncology, Milan, Italy.|2 Department of Health Sciences, University of Milan, Milan, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Ronchi
authors.affiliation: 1 Department of Radiotherapy, European Institute of Oncology, Milan, Italy.|2 Department of Health Sciences, University of Milan, Milan, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Ferrario
authors.affiliation: 1 Department of Radiotherapy, European Institute of Oncology, Milan, Italy.|2 Department of Health Sciences, University of Milan, Milan, Italy.
authors.forename: S P
authors.initials: SP
authors.lastname: Colangione
authors.affiliation: 1 Department of Radiotherapy, European Institute of Oncology, Milan, Italy.|2 Department of Health Sciences, University of Milan, Milan, Italy.
authors.forename: M A
authors.initials: MA
authors.lastname: Gerardi
authors.affiliation: 1 Department of Radiotherapy, European Institute of Oncology, Milan, Italy.|2 Department of Health Sciences, University of Milan, Milan, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Caputo
authors.affiliation: 1 Department of Radiotherapy, European Institute of Oncology, Milan, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Cecconi
authors.affiliation: 1 Department of Radiotherapy, European Institute of Oncology, Milan, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Gherardi
authors.affiliation: 1 Department of Radiotherapy, European Institute of Oncology, Milan, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Vavassori
authors.affiliation: 3 Department of Medical Physics, European Institute of Oncology, Milan, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Comi
authors.affiliation: 3 Department of Medical Physics, European Institute of Oncology, Milan, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Cambria
authors.affiliation: 3 Department of Medical Physics, European Institute of Oncology, Milan, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Garibaldi
authors.affiliation: 3 Department of Medical Physics, European Institute of Oncology, Milan, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Cattani
authors.affiliation: 2 Department of Health Sciences, University of Milan, Milan, Italy.|4 Department of Urology, European Institute of Oncology, Milan, Italy.
authors.forename: O
authors.initials: O
authors.lastname: De Cobelli
authors.affiliation: 1 Department of Radiotherapy, European Institute of Oncology, Milan, Italy.|2 Department of Health Sciences, University of Milan, Milan, Italy.|5 Clinical Division of the National Center of Oncological Hadrontherapy, Pavia, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Orecchia
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging / Q000379:methods; D009364:Neoplasm Recurrence, Local / Q000601:surgery*; D049268:Positron-Emission Tomography / Q000379:methods; D011471:Prostatic Neoplasms / Q000601:surgery*; D016634:Radiosurgery / Q000379:methods; D061089:Radiotherapy, Image-Guided / Q000379:methods; D050397:Radiotherapy, Intensity-Modulated / Q000379:methods; D012086:Reoperation; D012189:Retrospective Studies; D016879:Salvage Therapy / Q000379:methods; D014057:Tomography, X-Ray Computed / Q000379:methods