侷限性攝護腺癌病人接受根除性前列腺切除術或海福刀手術之
復發後補救性治療經驗
蔡佳宏1、江博暉1、方富民2
高雄長庚紀念醫院 泌尿科1，放射腫瘤科2
experiences of SALVAGE treatment FOR LOCALIZED PROSTATE CANCER recurrence after radical prostatectomy or hifu
Tsai-Chia Hung1, Po-Hui Chiang1, Fu-Min Fang2
Department of Urology1 and Radiation Oncology2, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
Purpose: We present our data of salvage radiotherapy after radical prostatectomy or HIFU and the result of salvage HIFU after HIFU, with the aim of determining efficacy and safety of these treatment sequence.
Materials and Methods: We retrospectively review the outcome of salvage radiotherapy for 42 patients after radical prostatectomy and 37 patients after HIFU with biochemical failure. We also review the outcome of 13 patients of who received secondary HIFU after the failure of primary HIFU.
Results: The salvage radiotherapy dose after radical prostatectomy is ranged from 6400cGy to 7200cGy and the dose after HIFU is ranged from 6600cGy to 7000cGy. The biochemical recurrence free survival after salvage radiotherapy was 85.7% in the radical prostatectomy group and 81.1% in the HIFU group, respectively (p=0.58). The biochemical recurrence free survival after secondary HIFU was 69.2%. One patient in radical prostatectomy group and two patients in HIFU group after salvage radiotherapy have complication of radiation proctitis (all grade 1). One patient in HIFU group has de novo urinary incontinence with pad after salvage radiation therapy. No patient has de novo urinary incontinence and rectal injury after salvage HIFU.
Conclusions: Our clinical results show that salvage radiotherapy for localized prostate cancer recurrence after radical prostatectomy or HIFU is effective and comparable (80-85%). The complication rates of salvage radiotherapy after radical prostatectomy or HIFU are low. The oncological outcomes after secondary HIFU is satisfactory without major complication. The sequence of primary treatment followed by salvage radiotherapy is less aggressive.