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. 2016:2016:9561494.
doi: 10.1155/2016/9561494. Epub 2016 Mar 22.

Salvage Brachytherapy for Biochemically Recurrent Prostate Cancer following Primary Brachytherapy

John M Lacy  1 , William A Wilson  2 , Raevti Bole  3 , Li Chen  4 , Ali S Meigooni  5 , Randall G Rowland  1 , William H St Clair  2
Affiliations

Salvage Brachytherapy for Biochemically Recurrent Prostate Cancer following Primary Brachytherapy

John M Lacy et al. Prostate Cancer. 2016.

Abstract

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.

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Figures

Figure 1
Figure 1
(a) Sample brachytherapy planning scans using BrachyVision software. (b) CT images showing seed distribution after reimplantation with and without reimplant isodose distributions.
Figure 2
Figure 2
IPSS scores throughout follow-up after salvage brachytherapy.
Figure 3
Figure 3
Effect of initial risk category on risk of biochemical recurrence.
See this image and copyright information in PMC

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