Keywords:
Toxicity, Radiotherapy techniques, Treatment effects, Intensity Modulated Radiotherapy (IMRT), Brachytherapy, CT, Genital / Reproductive system male, Oncology
Authors:
N. Mitina, K. Gogna, A. Gibbs, G. Wood; QLD/AU
DOI:
10.1594/ranzcr2016/R-0048
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 it was not available.
Information regarding recurrence location and,
where available,
Gleason score of the recurrent prostate cancer was collected and compared to the pre-treatment pathology.
The coverage of the target volume on the post-implant dosimetry,
Organs At Risk (OARs) dose and potential cold spot locations were reviewed and correlated to the recurrence locations.
Median and mean time from LDR brachytherapy until local recurrence were 65 months each (range 24 – 123 months).
All patients received an initial 3 months of androgen deprivation therapy (ADT) prior to EBRT and one patient continued on long term ADT.
Acute and late toxicities during and after EBRT were graded using Common Terminology Criteria for Adverse Events version 4.03 (CTCAE) [4].
EBRT treatment techniques were reviewed and data regarding prescribed dose and rectal maximum dose was collected.
Biochemical failure free survival after EBRT was recorded and median time to failure was calculated.
To assess current literature on the topic PubMed and Embase databases were searched in January 2016 using words “prostate” and/or “LDR” and/or “brachytherapy” and/or “external beam” and/or “salvage”.