A Phase II study of salvage high-dose-rate brachytherapy for the treatment of locally recurrent prostate cancer after definitive external beam radiotherapy Journal Article
| Authors: | Yamada, Y.; Kollmeier, M. A.; Pei, X.; Kan, C. C.; Cohen, G. N.; Donat, S. M.; Cox, B. W.; Zelefsky, M. J. |
| Article Title: | A Phase II study of salvage high-dose-rate brachytherapy for the treatment of locally recurrent prostate cancer after definitive external beam radiotherapy |
| Abstract: | Purpose: We report the toxicity and biochemical tumor control outcome of a prospective Phase II study using high-dose-rate brachytherapy (HDR) alone as a salvage therapy for recurrent disease after external beam radiotherapy (EBRT). Methods: Forty-two patients with biopsy-proven recurrence were enrolled on a Phase II study of salvage HDR monotherapy using iridium-192. Median pretreatment EBRT dose was 8100cGy (6840-8640cGy) and the median time from completion of EBRT to salvage HDR was 73 months. The protocol prescription dose of 3200cGy was delivered in four fractions over 30 hours in a single insertion. Median followup after salvage HDR was 36 months (6-67 months). Results: The actuarial prostate-specific antigen biochemical relapse-free survival and distant metastases-free survival rates at 5 years were 68.5% and 81.5%, respectively. Cause-specific survival was 90.3%. Late genitourinary Grade 1and 2 toxicities were found in 38% and 48%, respectively, and one patient developed Grade 3 urinary incontinence. Late Grade 1 and 2 gastrointestinal toxicity was noted in 17% and 8% of patients, respectively. Three patients (7%) developed Grade 2 late urinary toxicity (urethral stricture), which were corrected with urethral dilatation, and one patient developed Grade 3 urinary incontinence. No Grade 4 toxicities were observed. Conclusions: Genitourinary toxicity was the most commonly encountered toxicity observed after salvage HDR but severe toxicities were uncommon. Salvage HDR is an effective and well-tolerated modality for locally recurrent prostate cancer and should be considered even for patients who have previously been treated with ultra-high dose levels of EBRT. © 2014 American Brachytherapy Society. |
| Keywords: | salvage brachytherapy; high dose rate brachytherapy |
| Journal Title: | Brachytherapy |
| Volume: | 13 |
| Issue: | 2 |
| ISSN: | 1538-4721 |
| Publisher: | Elsevier Science, Inc. |
| Date Published: | 2014-03-01 |
| Start Page: | 111 |
| End Page: | 116 |
| Language: | English |
| DOI: | 10.1016/j.brachy.2013.11.005 |
| PROVIDER: | scopus |
| PUBMED: | 24373762 |
| PMCID: | PMC5718052 |
| DOI/URL: | |
| Notes: | Export Date: 2 April 2014 -- CODEN: BRACC -- Source: Scopus |
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