Clinical characteristics and acute side effects of salvage radiotherapy in biochemical recurrence of prostate cancer: A retrospective cohort study.

Abstract

e17004 Background: Biochemical recurrence (BCR) following radical prostatectomy poses a significant challenge in the management of prostate cancer. Salvage radiotherapy (SRT; 54 Gy in 18 fractions) is a widely adopted strategy to address BCR, aiming to improve disease control and survival outcomes. This study evaluates the clinical characteristics, treatment intervals, and reported side effects in a cohort of patients undergoing SRT for BCR of prostate cancer. Methods: We conducted a retrospective analysis of patients treated with SRT for BCR at Radioserra (Petrópolis, RJ, Brazil) from January 2023 to January 2025. Key variables included patient age, Gleason score, prostate-specific antigen (PSA) levels prior to radiotherapy, and the time interval between surgery and SRT initiation. Additionally, acute treatment-related side effects, such as dysuria and urinary frequency, were documented. Data were extracted from medical records, and descriptive statistics were employed to summarize the findings. Results: The cohort comprised 97 patients aged between 61 and 76 years, with a median Gleason score of 7 (range: 7–8). The time interval between prostatectomy and initiation of SRT ranged from 6 months to over 3 years. The PSA threshold for treatment was set at >0.2 ng/mL or persistently elevated PSA levels post-prostatectomy. Acute side effects were observed in 44 patients (53.6%), with dysuria reported in 12 patients (20.3%) and urinary frequency in 23 patients (39.0%) being the most common complaints. These findings align with the results of the RADICALS-RT trial, which demonstrated the feasibility and safety of SRT, while underscoring the importance of optimizing treatment timing to balance disease control and adverse effects. Conclusions: SRT remains a critical intervention for patients experiencing BCR of prostate cancer. This study highlights the variability in the timing of SRT initiation and the prevalence of acute urinary side effects. Further research is warranted to optimize treatment timing and mitigate adverse events, thereby enhancing patient outcomes in this setting.