Salvage Brachytherapy for Biochemically Recurrent Prostate Cancer following Primary Brachytherapy

الملخص EN

Purpose.

In this study, we evaluated our experience with salvage brachytherapy after discovery of biochemical recurrence after a prior brachytherapy procedure.

Methods and Materials.

From 2001 through 2012 twenty-one patients treated by brachytherapy within University of Kentucky or from outside centers developed biochemical failure and had no evidence of metastases.

Computed tomography (CT) scans were evaluated; patients who had an underseeded portion of their prostate were considered for reimplantation.

Results.

The majority of the patients in this study (61.9%) were low risk and median presalvage PSA was 3.49 (range 17.41–1.68).

Mean follow-up was 61 months.

At last follow-up after reseeding, 11/21 (52.4%) were free of biochemical recurrence.

There was a trend towards decreased freedom from biochemical recurrence in low risk patients ( p = 0.12 ).

International Prostate Symptom Scores (IPSS) increased at 3-month follow-up visits but decreased and were equivalent to baseline scores at 18 months.

Conclusions.

Salvage brachytherapy after primary brachytherapy is possible; however, in our experience the side-effect profile after the second brachytherapy procedure was higher than after the first brachytherapy procedure.

In this cohort of patients we demonstrate that approximately 50% oncologic control, low risk patients appear to have better outcomes than others.