Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2015 Jun;7(3):244-7.
doi: 10.5114/jcb.2015.51852. Epub 2015 May 28.

Second salvage treatment for local recurrence of prostate cancer using high-dose-rate brachytherapy: a case report

Audrey Claren  1 , Mathieu Gautier  2 , Julien Feuillade  2 , Alexander Tuan Falk  1 , Jean-Michel Hannoun Levi  1
Affiliations
Case Reports

Second salvage treatment for local recurrence of prostate cancer using high-dose-rate brachytherapy: a case report

Audrey Claren et al. J Contemp Brachytherapy. 2015 Jun.

Abstract

Purpose: Currently, there are no recommendations for the management of a second local recurrence of prostate adenocarcinoma except for the introduction of androgen deprivation therapy (ADT).

Case report: A 69-year-old man underwent a third salvage local treatment with high-dose-rate brachytherapy (HDRB), for a second biochemical relapse for local recurrence. Thirty-five Grays in 5 fractions were delivered on the whole prostate extended to the proximal part of left seminal vesicle. Given the availability of new treatment techniques in our radiation therapy department, a dosimetric comparison between HDRB and stereoatactic radiosurgery (SRS) was performed.

Results: Immediate tolerance of HDRB was acceptable with achievement of prostate specific antigen (PSA) nadir in 24 months (0.03 ng/ml). Observed late toxicities were only grade 2 urinary incontinence. Dosimetric comparison showed a slight advantage on clinical target volume coverage and rectum protection for the SRS. The HDRB showed an advantage on bone irradiation including femoral heads and the volume receiving 0.5 Gy (EQD2 = 1 Gy with α/β = 3).

Conclusions: A third local treatment with good tolerance could be a therapeutic option in case of a second local prostate cancer recurrence in order to delay, as long as possible, the chemical castration. Both techniques (HDRB and SRS) seem valid and should be chosen based on the availability and experience in a treatment center.

Keywords: brachytherapy; prostate cancer; recurrence; stereoatactic radiosurgery.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Reconstruction from the dosimetric CT-scan of the brachytherapy treatment. Pink: prostate and half of left seminal vesicle. Blue: urethra. Aquamarine: 10 implanted catheters for treatment. Green: canal anal. Brown: rectum
Fig. 2
Fig. 2
Prostate specific antigen (PSA) evolution (ng/ml)
Fig. 3
Fig. 3
Prostatic dose-distribution analysis on CT-scan axial slices for each treatment type. Prescribed dose: 35 Gy in 5 fractions. A) High-dose-rate brachytherapy. B) Stereotactic radiosurgery
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Cyran CC, Paprottka PM, Eisenblätter M, et al. Visualization, imaging and new preclinical diagnostics in. Radiat Oncol. 2014;9:3. - PMC - PubMed
    1. Studer UE, Whelan P, Wimpissinger F, et al. differences in time to disease progression do not predict for cancer-specific survival in patients receiving immediate or deferred androgen-deprivation therapy for prostate cancer: final results of EORTC randomized trial 30891 with 12 years of follow-up. Eur Urol. 2014;66:829–838. - PubMed
    1. Spratt DE, Scala LM, Folkert M, et al. A comparative dosimetric analysis of virtual stereotactic body radiotherapy to high-dose-rate monotherapy for intermediate-risk prostate cancer. Brachytherapy. 2013;12:428–433. - PubMed
    1. Prada PJ, Fernández J, Martinez AA, et al. Transperineal injection of hyaluronic acid in anterior perirectal fat to decrease rectal toxicity from radiation delivered with intensity modulated brachytherapy or EBRT for prostate cancer patients. Int J Radiat Oncol Biol Phys. 2007;69:95–102. - PubMed
    1. Cary KC, Singla N, Cowan JE, et al. Impact of androgen deprivation therapy on mental and emotional well-being in men with prostate cancer: analysis from the CaPSURE™ registry. J Urol. 2014;191:964–970. - PubMed

Publication types