Salvage Brachytherapy for Biochemically Recurrent Prostate Cancer following Primary Brachytherapy

Purpose. In this study, we evaluated our experience with salvage brachytherapy after discovery of biochemical recurrence after a prior brachytherapy procedure. Methods and Materials. From 2001 through 2012 twenty-one patients treated by brachytherapy within University of Kentucky or from outside centers developed biochemical failure and had no evidence of metastases.

Computed tomography (CT) scans were evaluated; patients who had an underseeded portion of their prostate were considered for reimplantation. Results. The majority of the patients in this study (61.9%) were low risk and median presalvage PSA was 3.49 (range 17.41-1.68). Mean follow-up was 61 months. At last follow-up after reseeding, 11/21 (52.4%) were free of biochemical recurrence. There was a trend towards decreased freedom from biochemical recurrence in low risk patients (p = 0.12). International Prostate Symptom Scores (IPSS) increased at 3-month follow-up visits but decreased and were equivalent to baseline scores at 18 months. Conclusions. Salvage brachytherapy after primary brachytherapy is possible; however, in our experience the side-effect profile after the second brachytherapy procedure was higher than after the first brachytherapy procedure. In this cohort of patients we demonstrate that approximately 50% oncologic control, low risk patients appear to have better outcomes than others.

Prostate cancer. 2016 Mar 22 [Epub]

John M Lacy, William A Wilson, Raevti Bole, Li Chen, Ali S Meigooni, Randall G Rowland, William H St Clair

Department of Urology, University of Kentucky College of Medicine, Lexington, KY 40536, USA., Department of Radiation Oncology, University of Kentucky College of Medicine, Lexington, KY 40536, USA., University of Kentucky College of Medicine, Lexington, KY 40536, USA., Department of Biostatistics, University of Kentucky College of Public Health, Lexington, KY 40536, USA., Comprehensive Cancer Centers of Nevada, Las Vegas, NV 89169, USA., Department of Urology, University of Kentucky College of Medicine, Lexington, KY 40536, USA., Department of Radiation Oncology, University of Kentucky College of Medicine, Lexington, KY 40536, USA.

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