eISSN: 2081-2841
ISSN: 1689-832X
Journal of Contemporary Brachytherapy
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2/2017
vol. 9
 
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abstract:
Case report

Second salvage high-dose-rate brachytherapy for radiorecurrent prostate cancer

Metha Maenhout
,
Marco van Vulpen
,
Marinus Moerland
,
Max Peters
,
Richard Meijer
,
Maurice van den Bosch
,
Paul Nguyen
,
Steven Frank
,
Jochem van der Voort van Zyp

J Contemp Brachytherapy 2017; 9, 2: 161–166
DOI: https://doi.org/10.5114/jcb.2017.67015
Online publish date: 2017/04/03
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Purpose: Salvage treatments for localized radiorecurrent prostate cancer can be performed safely when a focal and image guided approach is used. Due to the low toxicity, the opportunity exists to investigate a second salvage treatment when a second locally recurrent prostate cancer occurs. Here, we describe a second salvage treatment procedure of 4 patients.

Material and methods: Four patients with a pathologically proven second local recurrence were treated in an outpatient magnetic resonance imaging (MRI)-guided setting with a single fraction of 19 Gy focal high-dose-rate brachytherapy (HDR-BT). Delineation was performed using choline-PET-CT or a 68Ga-PSMA PET in combination with multiparametric 3 Tesla MRI in all four patients. Toxicity was measured using common toxicity criteria for adverse events (CTCAE) version 4.0.

Results: With a median follow-up of 12 months (range, 6-15), there were 2 patients with biochemical recurrence as defined by the Phoenix-definition. There were no patients with grade 3 or more toxicity. In all second salvage HDR-BT treatments, the constraints for rectum, bladder, and urethra were met. Median treatment volume (GTV) was 4.8 cc (range, 1.9-6.6 cc). A median of 8 catheters (range, 6-9) were used, and the median dose to the treatment volume (GTV) was a D95: 19.3 Gy (SD 15.5-19.4 Gy).

Conclusions: Second focal salvage MRI-guided HDR-BT for a select group of patients with a second locally recurrent prostate cancer is feasible. There was no grade 3 or more acute toxicity for these four patients.
keywords:

HDR brachytherapy, MRI guided, recurrent prostate cancer, second salvage treatment

  
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