Toxicity Profile and Patient-Reported outcomes following Salvage Stereotactic Body Radiotherapy (SBRT) to Pelvic Lymph nodes and Prostate Bed after Prostatectomy.

Resumen

Most of the current literature on salvage stereotactic body radiotherapy (SBRT) has focused on evaluating toxicity and efficacy outcomes limited to the prostate fossa. To date, no studies have systematically assessed the inclusion of elective nodal irradiation (ENI) in this context. This retrospective, single-center cohort study included 62 patients with prostate adenocarcinoma who experienced biochemical recurrence following radical prostatectomy and were treated with salvage SBRT to the prostatectomy bed and pelvic lymph node areas at Clínica Los Nogales (Bogotá, Colombia) between March and October 2023. Toxicities were assessed using CTCAE v5.0, and health-related quality of life (HRQOL) was evaluated using the EPIC-26 questionnaire. Grade 1 genitourinary (GU) toxicity occurred in 50% of patients and grade 2 in 29.3%, with no grade ≥3 GU toxicity reported. Gastrointestinal (GI) toxicity was reported as grade 1 in 20.7% and grade 2 in 12% of patients, with no grade ≥3 GI events. Prior to SBRT, 17% of patients had preserved sexual function, and 31% had full urinary continence. These findings suggest that salvage SBRT including ENI is feasible and well tolerated, with low rates of acute toxicity. The greatest HRQOL impact was observed in the sexual domain, highlighting the importance of early detection of biochemical recurrence to guide treatment decisions and potentially avoid systemic therapy.