alexa Low-dose-rate brachytherapy as salvage treatment of local prostate cancer recurrence after radical prostatectomy.


Journal of Nuclear Medicine & Radiation Therapy

Author(s): Traudt K, Ciezki J, Klein EA

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Abstract OBJECTIVES: To present our initial experience with brachytherapy used as a salvage procedure for local recurrence of prostate cancer in the prostatic fossa after radical prostatectomy. METHODS: The patients included 5 consecutive men who underwent brachytherapy as a salvage procedure after radical prostatectomy from December 2006 to March 2008. We used a technique of implanting the local recurrences similar to the American Brachytherapy Society Guidelines for implanting an intact prostate as definitive therapy. Two modifications were made related to the recurrence location: a rare need to manage urethral doses because the recurrence was typically perirectal, and more aggressive management of the dose to the rectum because of this proximity. RESULTS: All patients tolerated the brachytherapy procedure well and showed a decline in the prostate-specific antigen level, with a median nadir of 0.72 ng/mL at a median follow-up of 13 months. The postprocedural symptoms were minor and included limited new-onset urgency. At the last follow-up visit, all patients had prostate-specific antigen doubling times, which have been associated with long median survival times. CONCLUSIONS: Salvage brachytherapy for biopsy-proven local recurrence of prostate cancer is a technically feasible alternative to external beam radiotherapy for local control of recurrences in the prostatic fossa in selected patients after radical prostatectomy. Copyright © 2011 Elsevier Inc. All rights reserved. This article was published in Urology and referenced in Journal of Nuclear Medicine & Radiation Therapy

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