Management of local prostate cancer recurrence after initial treatment with Low Dose Rate (LDR) brachytherapy remains clinically challenging and salvage options might be limited.
There are no published trials assessing the feasibility and toxicity of salvage external beam radiotherapy (EBRT).
pelvic radiation is known to be employed by some institutions.
The purpose of our study was to review efficacy as well as acute and late toxicity of Intensity Modulated RadioTherapy (IMRT) with Image Guidance (IGRT) as a salvage option for patients experiencing...
Methods and materials
We performed a retrospective analysis of the medical records of 10 consecutive male patients who were treated in Radiation Oncology Mater Centre (ROMC) with EBRT for local failure after initial LDR brachytherapy for low and intermediate risk prostate cancer.
Median patient age was 66 years (range 58 – 74 years) at the time of the salvage treatment.
All local recurrences were biopsy proven and there was no evidence of metastatic disease on re-staging CT and bone scans.
Staging did not include PSMA PET scan as...
Only eight patients had a documented recurrent prostate cancer location and Gleason score.
For one patient the recurrence Gleason score was lower than at the time of the initial diagnosis,
in two cases Gleason score was not assigned and in all other cases it was higher than at the initial diagnosis.
That could be due to the natural disease progression or due to sampling uncertainties (all patients initially had mapping biopsies but no dominant nodule sampling).
There was no visible correlation between the initial mapping...
Our limited experience indicates that salvage EBRT utilising IMRT technique could be considered as a feasible option for patients with local prostate cancer recurrence after initial LDR brachytherapy.
Obtained data shows acceptable acute and late treatment morbidity with no grade 4-5 late GI or GU toxicity.
Further research with prospective data collection and employment of modern imaging modalities including MRI and PSMA-PET scans is required to validate our findings.
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