title: Salvage brachytherapy for seminal vesicle recurrence after initial brachytherapy for prostate cancer: a case report.
abstract: BACKGROUND
  To report the efficacy and safety of salvage brachytherapy for seminal vesicle recurrence after initial brachytherapy in a patient with prostate cancer. As far as we know, this is a first report of salvage brachytherapy for seminal vesicle recurrence in Japan.
  
  
  METHODS
  A 70-year-old Japanese man with low-risk prostate cancer received low-dose-rate brachytherapy. Forty-two months after the seed implantation, he showed biochemical recurrence based on the nadir + 2 ng/mL definition. The prostate specific antigen (PSA) level was 5.11 ng/mL at 58 months after seed implantation. A saturation biopsy of the prostate showed no recurrence. Systemic screening also showed no distant metastases. However, T2-weighted magnetic resonance imaging (MRI) demonstrated a low intensity area at the base of the right seminal vesicle, which was strongly suggestive of recurrence. Sixty months after the initial therapy, a seminal vesicle biopsy confirmed recurrence with a Gleason score of 4 + 3 before salvage brachytherapy was performed. The prescribed dose was 145 Gy, the same as the dose of the initial therapy. One month later, the PSA level had rapidly declined to 0.898 ng/mL without androgen deprivation therapy. Ten months after the salvage brachytherapy, the PSA level reached 0.078 ng/mL. No adverse events were seen during the follow-up period.
  
  
  CONCLUSIONS
  We experienced a patient who was successfully treated with salvage brachytherapy for seminal vesicle recurrence. Salvage brachytherapy is one of the promising therapeutic options for recurrence after initial brachytherapy.
authors.forename: Shunta
authors.initials: S
authors.lastname: Hori
authors.affiliation: Department of Urology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan. sendo@naramed-u.ac.jp.
authors.forename: Nobumichi
authors.initials: N
authors.lastname: Tanaka
authors.forename: Isao
authors.initials: I
authors.lastname: Asakawa
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Morizawa
authors.forename: Akihide
authors.initials: A
authors.lastname: Hirayama
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Hasegawa
authors.forename: Noboru
authors.initials: N
authors.lastname: Konishi
authors.forename: Kiyohide
authors.initials: K
authors.lastname: Fujimoto
mesh_terms: D000368:Aged; D001918:Brachytherapy; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging / Q000532:radiotherapy*; D010388:Pelvis / Q000000981:diagnostic imaging; D011471:Prostatic Neoplasms / Q000000981:diagnostic imaging / Q000532:radiotherapy*; D016879:Salvage Therapy; D012669:Seminal Vesicles / Q000000981:diagnostic imaging / Q000473:pathology*; D014057:Tomography, X-Ray Computed