Clinically significant prostate cancer local recurrence after radiation therapy occurs at the site of primary tumor: Magnetic resonance imaging and step-section pathology evidence Journal Article


Authors: Pucar, D.; Hricak, H.; Shukla-Dave, A.; Kuroiwa, K.; Drobnjak, M.; Eastham, J.; Scardino, P. T.; Zelefsky, M. J.
Article Title: Clinically significant prostate cancer local recurrence after radiation therapy occurs at the site of primary tumor: Magnetic resonance imaging and step-section pathology evidence
Abstract: Purpose: To determine whether prostate cancer local recurrence after radiation therapy (RT) occurs at the site of primary tumor by retrospectively comparing the tumor location on pre-RT and post-RT magnetic resonance imaging (MRI) and using step-section pathology after salvage radical prostatectomy (SRP) as the reference standard. Methods and Materials: Nine patients with localized prostate cancer were treated with intensity modulated RT (69-86.4 Gy), and had pre-RT and post-RT prostate MRI, biopsy-proven local recurrence, and SRP. The location and volume of lesions on pre-RT and post-RT MRI were correlated with step-section pathology findings. Tumor foci >0.2 cm3 and/or resulting in extraprostatic disease on pathology were considered clinically significant. Results: All nine significant tumor foci (one in each patient; volume range, 0.22-8.63 cm3) were detected both on pre-RT and post-RT MRI and displayed strikingly similar appearances on pre-RT and post-RT MRI and step-section pathology. Two clinically insignificant tumor foci (≤0.06 cm3) were not detected on imaging. The ratios between tumor volumes on pathology and on post-RT MRI ranged from 0.52 to 2.80. Conclusions: Our study provides a direct visual confirmation that clinically significant post-RT local recurrence occurs at the site of primary tumor. Our results are in agreement with reported clinical and pathologic results and support the current practice of boosting the radiation dose within the primary tumor using imaging guidance. They also suggest that monitoring of primary tumor with pre-RT and post-RT MRI could lead to early detection of local recurrence amenable to salvage treatment. © 2007 Elsevier Inc. All rights reserved.
Keywords: adult; clinical article; aged; middle aged; retrospective studies; cancer localization; cancer recurrence; intensity modulated radiation therapy; salvage therapy; cancer patient; cancer radiotherapy; comparative study; radiation dose; nuclear magnetic resonance imaging; magnetic resonance imaging; neoplasm recurrence, local; tumor volume; radiotherapy dosage; radiotherapy; tumor biopsy; pathology; oncology; retrospective study; prostate cancer; prostatic neoplasms; prostate; tumors; radiotherapy, intensity-modulated; tumor burden; prostatectomy; tumor recurrence; prostate tumor; radiation therapy; prostate cancers; salvage radical prostatectomy; local recurrence; medical problems; salvage radical prostatectomy (srp)
Journal Title: International Journal of Radiation Oncology, Biology, Physics
Volume: 69
Issue: 1
ISSN: 0360-3016
Publisher: Elsevier Inc.  
Date Published: 2007-09-01
Start Page: 62
End Page: 69
Language: English
DOI: 10.1016/j.ijrobp.2007.03.065
PUBMED: 17707266
PROVIDER: scopus
DOI/URL:
Notes: --- - "Cited By (since 1996): 25" - "Export Date: 17 November 2011" - "CODEN: IOBPD" - "Source: Scopus"
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MSK Authors
  1. Kentaro Kuroiwa
    28 Kuroiwa
  2. Michael J Zelefsky
    661 Zelefsky
  3. Peter T Scardino
    631 Scardino
  4. Darko Pucar
    12 Pucar
  5. Hedvig Hricak
    349 Hricak
  6. James Eastham
    446 Eastham
  7. Amita Dave
    85 Dave