Validating Modern NRG Oncology Pelvic Nodal and GFRU Prostate Bed Contouring Guidelines for Post-prostatectomy Salvage Radiation: A Secondary Analysis of the LOCATE Trial. Journal Article

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Authors: Harmon, G; Chan, D; Lee, B; Miller, C; Gorbonos, A; Gupta, G; Quek, M; Woods, M; Savir-Baruch, B; Harkenrider, MM; Solanki, AA
Article Title: Validating Modern NRG Oncology Pelvic Nodal and GFRU Prostate Bed Contouring Guidelines for Post-prostatectomy Salvage Radiation: A Secondary Analysis of the LOCATE Trial.
Abstract: PURPOSE: We used the patterns of recurrence on F-fluciclovine PET/CT in post-prostatectomy patients enrolled in the XXXX trial to evaluate how well the most recent NRG Oncology and Groupe Francophone de RadiotheĢrapie Urologique (GFRU) contouring recommendations encompassed all sites of recurrence in the prostate fossa and pelvic nodes in comparison to former Radiation Therapy Oncology Group (RTOG) recommendations. METHODS: Patients with biochemically recurrent prostate cancer after radical prostatectomy with a positive finding within the prostate fossa or pelvic nodes on F-fluciclovine PET/CTs were identified from the XXXX patient population. Areas of gross disease were delineated. Prostate fossa contours were delineated using both the 2010 RTOG consensus guidelines, as well as the recently published 2020 GFRU consensus guidelines. Pelvic nodes were contoured with both the 2009 RTOG consensus guidelines and the 2020 NRG consensus guidelines. The performance of the contouring guidelines was assessed by determining what proportion of gross recurrent lesions were encompassed completely or marginally. RESULTS: Of the 213 patients within the XXXX trial, a total of 45 patients were eligible for analysis with positive F-fluciclovine PET findings. Of the 30 total prostate fossa recurrences, the 2010 RTOG contour covered 20 (67%), and missed or marginally covered 10 (33%). The 2020 GFRU contour covered 27 (90%) recurrences, and missed or marginally covered 3 (10%). Of the 43 total nodal recurrences, the 2009 RTOG pelvic nodal contour covered 29 nodes (67%), and missed or marginally covered 14 (32%). The 2020 NRG pelvic nodal contour covered 43 nodes (100%), with no misses or marginal coverage. CONCLUSION: This secondary analysis of the XXXX trial exemplifies the improved coverage of the latest prostate fossa contouring recommendations from the GFRU. Similarly, it also validates the updated 2020 NRG pelvic nodal contouring guidelines by demonstrating improved coverage of recurrent disease in this patient population.
Journal Title: International journal of radiation oncology, biology, physics
ISSN: 1879-355X; 0360-3016
Publisher: Elsevier Inc  
Date Published: 2021