Salvage brachytherapy for recurrent prostate cancer.
Brachytherapy
; 13(1): 53-8, 2014.
Article
em En
| MEDLINE
| ID: mdl-24295965
ABSTRACT
PURPOSE:
To evaluate the role of salvage prostate brachytherapy for locally recurrent prostate cancer after external beam radiation alone. METHODS AND MATERIALS Sixty-nine consecutive patients treated with salvage brachytherapy after a local failure were analyzed. All patients were found to have pathologic proven recurrent prostate cancer at least 2 years after initial therapy and no regional or distant disease on imaging studies. Pd-103 was used with a prescribed pD90 of 100 Gy. In total, 89.9% of patients received androgen suppression (AS) as part of their salvage therapy. Patients whose prostate-specific antigen >5.0 ng/mL while on AS were considered to have castration resistant prostate cancer (CRPC). Patients on AS >6 months before salvage brachytherapy were considered to have delayed therapy. Patients retreated within 5 years after their initial treatment were considered to have early failures.RESULTS:
Total median followup after salvage therapy was 5.0 years (0.6-13.7). From the date of salvage, 5-year biochemical control for low-risk patients was 85.6%, intermediate-risk patients 74.8%, and high-risk patients 66%. Five-year biochemical control was 73.8% for non-CRPC and 22% for CRPC cases (<0.001). Including and excluding CRPC cases, early treatment after failure vs. delayed treatment was significantly better (p<0.05). Chronic adverse events were seen in few patients, with genitourinary Grade 3 toxicity of 8.7% and no genitourinary Grade 4 or gastrointestinal Grade 3 or higher toxicities.CONCLUSIONS:
A subset of failures after definitive radiation is local in nature, and excellent control is possible with salvage brachytherapy.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Neoplasias da Próstata
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Braquiterapia
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Terapia de Salvação
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Recidiva Local de Neoplasia
Limite:
Aged
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Aged80
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Brachytherapy
Assunto da revista:
RADIOTERAPIA
Ano de publicação:
2014
Tipo de documento:
Article