Prospective study of salvage stereotactic radiotherapy for macroscopic prostate bed recurrence after prostatectomy

The prospective STARR trial in Italy evaluates salvage stereotactic radiotherapy (35 Gy in 5 fractions) for patients with macroscopic local recurrence after prostatectomy. Interim analysis of the trial found that with a median follow-up of 16 months, complete biochemical response (PSA < 0,2 ng/ml) was achieved in 45% of the patients and biochemical response ( ≥ 50% PSA reduction) in 80%. Median biochemical recurrence-free survival, radiological recurrence-free survival, and ADT-free survival were not reached. Toxicity was minimal, with no grade ≥ 3 toxicities. The authors conclude that these early results suggest that salvage stereotactic radiotherapy is a safe and effective option for macroscopic local recurrence after prostatectomy.