Intensity-modulated salvage radiotherapy with simultaneous integrated boost for local recurrence of @entity263 : a pilot study on the place of PET- XXXX for guiding target volume delineation.

@entity1 @entity137 @entity263 @entity22317 @entity344 @entity1877
OBJECTIVE: The aim of this study was to report the first cases of salvage radiotherapy (RT) using the intensity-modulated radiotherapy (IMRT) with simultaneous integrated boost (SIB) targeted on @entity1877 positron emission tomography (PET) uptake in a local recurrent @entity263 , after a radical prostatectomy. METHODS: Four @entity1 received salvage irradiation for biochemical relapse that occurred after the initial radical prostatectomy. The relapse occurred from 10 months to 6 years with PSA levels ranging from 2.35 to 4.86   ng   ml(-1). For each @entity1 , an @entity22317 PET-CT showed a focal @entity1877 uptake in prostatic fossa, with standardized uptake value calculated on the basis of predicted lean body mass (SUL) max of 3.3-6.8. No involved lymph node or distant metastases were diagnosed. IMRT doses were of 62.7   Gy (1.9   Gy/fraction, 33 fractions), with a SIB of 69.3   Gy (2.1   Gy/fraction, 33 fractions) to a PET-guided target volume. RESULTS: Acute @entity137 were limited. We observed no @entity344 >= grade 2 and only one grade 2 genitourinary @entity137 . At 1-month follow-up evaluation, no complication and a decrease in PSA level (6.8-43.8% of the pre-therapeutic level) were reported. After 4 months, a decrease in PSA level was obtained for all the @entity1 , ranging from 30% to 70%. At a median follow-up of 15 months, PSA level was controlled for all the @entity1 , but one of them experienced a distant lymph node recurrence. CONCLUSION: Salvage irradiation to the prostate bed with SIB guided by PET-CT is feasible, with biological efficacy and no major acute @entity137 . Advances in knowledge: IMRT with PET-oriented SIB for salvage treatment of @entity263 is possible, without major acute @entity137 .
