Radiotherapy Technique in Patients with Regional Recurrence of Prostate Cancer after Surgical Treatment

Purpose: Improving the results of combined treatment of patients with regional recurrence of prostate cancer (PCa) after surgical treatment using an original radiotherapy technique. Materials and methods:A singlecenter retro and prospective cohort study included patients with regional recurrence of PCa after radical prostatectomy (RP) without signs of distant metastasis who underwent salvage radiation therapy (SRT). This approach includes threedimensional conformal radiation therapy using radiation therapy technology with VMAT based on the principle of a SIB with radiation exposure to regional lymph nodes: common, external and internal iliac, presacral with a dose per fraction of 1.82 Gy to 46.8 Gy, the bed of the fossa of prostate gland and/or lymph node metastases with 2.352.4 Gy per fraction to 6672 iGy, the area of local recurrence with 2.5 Gy to 7274 iGy and simultaneous prophylactic radiation exposure to retroperitoneal lymph nodes with 1.82 Gy per fraction to 50 Gy. The primary endpoint is 3year progressionfree survival (PFS). Secondary endpoints are 3-year metastaticfree survival (MFS), locoregional control. Results: In the period 20192023, 41 patients with biochemical recurrence and metastases of PCa to the regioal lymph nodes after RP underwent SRT with a median followup of 3 years. 3 and 5year PFS were 85.1 % and 70.9 %. 3 and 5year MFS are 88.7 % and 73.3 %. Locoregional control – 100 %. Conclusion: The maximally intensified approach in the combined hormonoradiation treatment of patients with PCa and metastases to the lymph nodes of the pelvis after RP is a promising effective treatment scenario for this difficult prognostically unfavorable group of patients. However, a final assessment of the oncological significance of this approach requires obtaining the final results of a prospective randomized phase III trial.