Focal salvage high-dose-rate brachytherapy with implantable rectum spacer for locally recurrent prostate cancer after initial low-dose-rate with grade 3 rectal toxicity

Thirza Opbroek; Anne Cobussen; Evert J. Van Limbergen; Ben G.L. Vanneste

doi:10.5114/jcb.2023.126051

eISSN: 2081-2841
ISSN: 1689-832X

Journal of Contemporary Brachytherapy

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2/2023
vol. 15

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abstract:

Case report

Focal salvage high-dose-rate brachytherapy with implantable rectum spacer for locally recurrent prostate cancer after initial low-dose-rate with grade 3 rectal toxicity

Thirza Opbroek

¹

,

Anne Cobussen

¹

,

Evert J. Van Limbergen

¹

,

Ben G.L. Vanneste

^{1, 2}

Department of Radiation Oncology (MAASTRO), GROW – School for Oncology and Developmental Biology, Maastricht University Medical Center+, Maastricht, The Netherlands
Department of Human Structure and Repair, Department of Radiation Oncology, Ghent University Hospital, Belgium

J Contemp Brachytherapy 2023; 15, 2: 154–158

DOI: https://doi.org/10.5114/jcb.2023.126051

Online publish date: 2023/03/22

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AMA

Opbroek T, Cobussen A, Van Limbergen E, Vanneste B. Focal salvage high-dose-rate brachytherapy with implantable rectum spacer for locally recurrent prostate cancer after initial low-dose-rate with grade 3 rectal toxicity. Journal of Contemporary Brachytherapy. 2023;15(2):154-158. doi:10.5114/jcb.2023.126051.

APA

Opbroek, T., Cobussen, A., Van Limbergen, E.,  & Vanneste, B. (2023). Focal salvage high-dose-rate brachytherapy with implantable rectum spacer for locally recurrent prostate cancer after initial low-dose-rate with grade 3 rectal toxicity. Journal of Contemporary Brachytherapy, 15(2), 154-158. https://doi.org/10.5114/jcb.2023.126051

Chicago

Opbroek, Thirza, Anne Cobussen, Evert J. Van Limbergen,  and Ben G.L. Vanneste. 2023. "Focal salvage high-dose-rate brachytherapy with implantable rectum spacer for locally recurrent prostate cancer after initial low-dose-rate with grade 3 rectal toxicity". Journal of Contemporary Brachytherapy 15 (2): 154-158. doi:10.5114/jcb.2023.126051.

Harvard

Opbroek, T., Cobussen, A., Van Limbergen, E.,  and Vanneste, B. (2023). Focal salvage high-dose-rate brachytherapy with implantable rectum spacer for locally recurrent prostate cancer after initial low-dose-rate with grade 3 rectal toxicity. Journal of Contemporary Brachytherapy, 15(2), pp.154-158. https://doi.org/10.5114/jcb.2023.126051

MLA

Opbroek, Thirza et al. "Focal salvage high-dose-rate brachytherapy with implantable rectum spacer for locally recurrent prostate cancer after initial low-dose-rate with grade 3 rectal toxicity." Journal of Contemporary Brachytherapy, vol. 15, no. 2, 2023, pp. 154-158. doi:10.5114/jcb.2023.126051.

Vancouver

Opbroek T, Cobussen A, Van Limbergen E, Vanneste B. Focal salvage high-dose-rate brachytherapy with implantable rectum spacer for locally recurrent prostate cancer after initial low-dose-rate with grade 3 rectal toxicity. Journal of Contemporary Brachytherapy. 2023;15(2):154-158. doi:10.5114/jcb.2023.126051.

Purpose:
Locally recurrent prostate cancer after previous radiation therapy remains challenging. One of the curative options for these patients is salvage brachytherapy. There are no reports available on the use of a biodegradable rectal balloon implantation (RBI) in combination with brachytherapy in patients with recurrent prostate cancer after previous radiotherapy.

Case presentation:
Here, we report on a patient with a local recurrence at five years after previous low-dose-rate brachytherapy with a prescribed dose of 145 Gray (Gy) for a low-risk prostate adenocarcinoma. The patient experienced grade 3 rectal toxicity, which was resolved at the time of local recurrence. He was treated with focal high-dose-rate (HDR) brachytherapy of 2 fr. × 13 Gy after RBI implantation. Four years post-salvage treatment, there was no evidence of biochemical recurrence according Phoenix definition, and no gastro-intestinal or genitourinary toxicity.

Conclusions:
This case describes the use of RBI implantation in combination with a focal salvage HDR in a patient with recurrent disease, with significant initial grade 3 rectal toxicity after previous irradiation. The use of a biodegradable RBI proved to be a promising solution for such a patient; however, this method needs to be further investigated.

keywords:

Focal salvage high-dose-rate brachytherapy with implantable rectum spacer for locally recurrent prostate cancer after initial low-dose-rate with grade 3 rectal toxicity

Thirza Opbroek 1 , Anne Cobussen 1 , Evert J. Van Limbergen 1 , Ben G.L. Vanneste 1, 2

prostate cancer, brachytherapy, salvage therapy, rectal balloon implant

Thirza Opbroek

¹

,

Anne Cobussen

¹

,

Evert J. Van Limbergen

¹

,

Ben G.L. Vanneste

^{1, 2}